WHAT 

SHALL 

I   EAT? 

DR.  F.  X.  GOTJBATJD 


Southern  Branch 
of  the 

University  of  California 

Los  Angeles 

Form  L-l 


This  book  is  DUE  on  last  date  stamped  below 


ANGELES,  CALIF. 


WHAT  SHALL   I   EAT? 


WHAT 

SHALL 

I   EAT? 

A   MANUAL   OF  RATIONAL  FEEDING 

BY 

DR.    F.    X.    GOURAUD 

Formerly  Chief  of  the  Laboratory  of  the  Medical  Faculty  of  Paris 

With  a  Preface  by  PROF.  ARMAND  GAUTIER,  of  Paris 

ONLY  AUTHORIZED    TRANSLATION 
INTO     THE     ENGLISH    LANGUAGE 

BY 

FRANCIS    J.  REBMAN 

WITH  A  GLOSSARY  CONTAINING  DEFINITIONS  OF  THE  PRINCIPAL 

TECHNICAL  TERMS,   AND  AN  INDEX  OF  DISEASES 

REFERRED  TO  IN  THE  TEXT 


NEW   YORK 
REBMAN    COMPANY 

1123    BROADWAY 


COPYRIGHT,  1911,  BY 

REBMAN  COMPANY 

NEW  YORK 

Entered  at  Stationers'  Hall,  London,  1911 


All  Rights  reserved 


PRINTED  IN  AMERICA 


Gr  "4  E 


TRANSLATOR'S  PREFACE 

(9 

rJ        IN  reading  this  book  in  the  vernacular,  I  was 
struck  by  the  practical  manner  in  which  the  au- 
thor deals  with  the  subject  before  him,   and  I 
considered  it  advisable  to  present  his  views  to  the 
^   English-speaking  public.     The   style  is  facile, 
succinct,  and  very  readable.     He  gives  an  im- 
J  partial  survey  of  the  burning  questions  of  the 
-  day  and,  by  advancing  the  arguments  of  oppos- 
~  ing  authorities,  leaves  it  to  the  reader  to  arrive 
^  at  his  own  conclusions.     Read  the  book  and  you 
will  understand  what  I  mean  to  convey. 

His  opinions  on  the  questions  of  alcohol, 
white  bread,  and  vegetarianism  are  interesting 
and  worth  studying,  as  they  strike  a  keynote 
on  the  discussion  of  these  important  factors  of 
modern  diet. 

The  striking  feature  of  the  book  lies  in  its 
arrangement.  The  author  gives  for  each  article 
of  food  mentioned  in  the  book  the  actions  on 
the  digestive  functions,  on  assimilation,  secre- 
tion, and  elimination.  This  is  important.  He 


vi  TRANSLATOR'S    PREFACE 

likewise  gives  the  reasons  why  a  food  should  be 
employed  or  rejected,  according  to  the  normal  or 
pathological  conditions  of  each  individual  case. 
Indications  and  contraindications  are  given  in 
every  instance,  which  makes  the  choice  of  food 
adapted  to  each  case  easy. 

The  book  deserves  a  place  on  the  five-foot 
shelf  of  every  medical  man — in  fact  of  every 
thinking,  intelligent  person  in  the  land,  who 
takes  an  interest  in  the  hygiene  of  the  kitchen, 
the  proper  choice  of  food  for  the  table,  and  a 
rational  care  of  the  body. 

The  business  man  will  derive  benefit  from  its 
perusal;  the  educated  housewife  will  find  in  it 
many  hints  that  enhance  the  management  of 
the  kitchen;  and  the  afflicted  as  well  as  the  con- 
valescent will  be  encouraged  to  turn  to  its  pages 
with  profit  and  satisfaction. 

For  the  better  understanding  of  the  technical 
terms  employed,  I  have  added,  at  the  end  of  the 
book,  a  glossary  containing  definitions  of  the 
most  important  medical  and  scientific  expres- 
sions used  in  the  text.  This  glossary  does  not 
appear  in  the  original  edition. 

F.  J.  REBMAN. 

1123   BROADWAY,    NEW  YORK. 


PREFACE 

PEOPLE  generally — alas,  too  often — follow  old- 
fashioned  and  stereotyped  rules  in  their  daily 
diet,  such  as:  "When  hungry,  eat."  "What  is 
eaten  with  relish,  does  no  harm."  "When  the 
stomach  calls,  everything  tastes  good. ' '  Many 
believe  that  every  one  should  follow  his  own 
tastes  and  inclinations  and  should  loyally  ad- 
here to  personal  predilections  and  to  the  habits 
formed  in  early  life.  But  are  not  these  habits 
due  rather  to  circumstances,  i.e.,  influences — 
good  or  evil — that  surround  us?  Likewise  to 
prevailing  fashions,  local  customs,  to  current 
ideas  and  to  individual  caprices  and  prejudices, 
etc.,  i.e.,  conditions  which  are  calculated  to 
create  artificial  wants  that  often  enough  entail 
threatening  and  dangerous  symptoms?  Not 
unlike  to  the  opium-smoker,  does  the  heavy 
meat-eater,  for  instance,  experience  that  feeling 
of  ungratified  appetite,  as  though  something 
were  still  wanting,  when  he  cannot  get  his  fa- 
vorite food  to  excess. 


viii  PREFACE 

This  peculiar  illusion  is  strangely  and  strong- 
ly marked  in  cases  of  morphinism,  of  alcoholism, 
and  of  nicotinism.  It  is  an  error  into  which  the 
happy  man  is  apt  to  fall  who  thinks  that  he  is 
doing  the  right  thing  when,  with  a  copious  and 
succulent  meal,  he  appeases  a  merely  imaginary 
craving.  The  same  mistake  is  made  by  the  work- 
ing man  who  drinks  for  the  avowed  purpose  of 
bracing  himself  up  for  his  task,  or  to  make  up 
for  underfeeding,  but  who  does  not  drink  sim- 
ply for  the  sake  of  the  pleasure  and  bodily  grat- 
ification derived  from  the  beverage. 

Yet  there  must  of  necessity  be  certain  laws, 
rules,  or  regulations  by  which  our  diet  is  to 
be  governed.  The  food  question  is  paramount 
in  man's  life;  his  very  existence  depends  on  it. 
It  has  engaged  the  serious  attention  of  physiolo- 
gists, eminent  physicians,  chemists,  sociologists, 
and  even  moralists.  In  recent  years  the  follow- 
ers of  Atwater  have  taken  up  this  study,  and 
have  demonstrated  the  social  and  hygienic  ad- 
vantages that  accrue  from  feeding  the  masses 
properly.  They  also  point  out  the  necessity  for 
teaching  those  who  depend  for  their  living  on 
the  work  of  their  hands,  how  to  feed  and  how 
to  procure,  at  the  smallest  possible  outlay,  the 


PREFACE  ix 

food  best  adapted  to  their  physical  needs.  The 
medical  profession  is  nowadays  well  equipped, 
by  personal  study  and  observation  as  well  as  by 
the  aid  of  researches  made  by  able  and  clever 
chemists,  to  understand  and  regulate  the  ques- 
tion of  alimentation,  in  the  sick-room  particu- 
larly, with  judgment  and  precision.  Many  ex- 
cellent books  have  been  written  on  the  subject, 
and  much  good  has  been  achieved  by  the  dis- 
semination of  this  wholesome  literature. 

Touching  on  this  point  leads  me  to  refer  here 
particularly  to  Dr.  Gouraud's  new  book.  Dr. 
Gouraud  was  formerly  the  chief  of  the  labora- 
tory of  the  Medical  Faculty  of  Paris,  and  also 
the  intern  of  several  hospitals.  In  both  capac- 
ities he  earned  well-deserved  distinction.  His 
book  is  clear,  succinct,  and  practical.  He  tells 
everything  that  is  of  importance  and  all  that 
is  essential  for  a  medical  man  to  know.  The 
author  quotes  for  each  article  of  food — meat, 
milk,  eggs,  bread,  pulse,  wine,  etc. — the  reac- 
tions produced  on  the  digestive  functions,  on 
assimilation,  on  the  secretions,  and  on  the  ap- 
paratus of  elimination.  He  also  enumerates  the 
reasons  for  the  employment  or  rejection  of  each 
food  according  to  the  constitution  and  the  state 


x  PREFACE 

of  health  of  the  individual.  This  is  an  ingeni- 
ous form  of  presenting  the  subject,  for  it  allows 
of  determining  at  once  what  alimentary  sub- 
stances may  be  permitted  to  enter  into  any 
given  diet  or  regimen,  and  clearly  points  out 
the  indications  and  contraindications  for  their 
employment. 

It  gives  me  pleasure  to  recommend,  in  strong 
terms  of  approval,  this  book  to  the  medical  read- 
er, for  it  is  preeminently  practical  and  cleverly 
conceived.  I  know  of  no  better  guide. 

ARMAND  GAUTIER. 

PARIS,  FRANCE. 


TABLE  OF   CONTENTS 

PAGE 

PREFACES v  and  vii 

INTRODUCTION  .  3 


MEAT 

BUTCHER'S   MEAT 19 

Beef 20 

Composition — Alimentary  Value 20 

Methods  of  Preparation 23 

Reactions    27 

Indications  and  Contraindications 33 

Preserved  Meats 44 

Veal 46 

Horse-meat 47 

Mutton 48 

Pork   48 

Gelatinous  Substances 50 

Organs  Rich  in  Nuclein 52 

Liver 52 

Kidney 53 

Sweetbread 54 

Brain 55 

Marrow   56 

Delicatessen 57 

Some  Particulars 59 

POULTRY   AND   BARNYARD    MEATS 61 

Composition — Alimentary  Value 61 

Methods  of  Preparation 61 

Reactions — Indications 62 

xi 


xii  TABLE   OF  CONTENTS 

PAGE 

GAME 64 

Composition— Alimentary  Value 64 

Methods  of  Preparation 64 

Reactions — Indications 66 

EXTRACTS   MADE   FROM   MEAT 68 

Soup — Bouillon 68 

Juice  of  Meat 73 

Extract  of  Beef 74 

Meat  Powder 75 

Peptones 76 

FISH 

LESS   FATTY  FISH 80 

Composition — Alimentary  Value 80 

Methods  of  Preparation 81 

Reactions 82 

Indications  and  Contraindications 84 

FATTY   FISH..  85 


CRUSTACEANS    AND    SHELL-FISH 

Composition — Reactions — Indications   


MILK 

Composition — Alimentary  Value 94 

Cow's  Milk 95 

Mother's  Milk 100 

Ass's  Milk 101 

Mare's  Milk 102 

Goat's  Milk 102 

Methods  of  Preparation 102 

Adulterations 107 

Reactions   109 


TABLE   OF   CONTENTS  xiii 


Milk  Diet  (Absolute) 113 

Indications  and  Contraindications 117 

Derivatives  of  Milk 126 

Butter-milk 126 

Whey 127 

Kephir 128 

Koumys 131 

Yoghourt  (Curdled  Milk) 132 

CHEESE 

Fresh   Unsalted 135 

Cooked 136 

With  Unbaked  Crust  (Salted  and  Unsalted) 138 

FATS— GREASE— BUTTER— OIL 

Composition  and  Properties 141 

Reactions 144 

Indications  and  Contraindications 146 

EGGS 

Composition — Alimentary  Value 151 

Methods  of  Preparation 154 

Changes 158 

Reactions   159 

Indications  and  Contraindications 162 

CEREALS 

General  Characteristics 167 

Special  Characteristics 175 

Barley 175 

Oats 176 

Rice 177 

Maize 180 

Rye 181 

Buckwheat 182 

Wheat  .  .  182 


xiv  TABLE   OF  CONTENTS 

BREAD 

PAGE 

Composition — Alimentary  Value 185 

Reactions   188 

Indications  and  Contraindications 191 

Value  of  White  Bread 194 

Biscuits — Crackers 200 

Pastry 201 

Pastes  (Nutritious) 204 

Chestnuts   206 

LEGUMES— PULSE 

Composition  and  Food  Value 207 

Methods  of  Preparation 210 

Reactions 212 

Particulars 215 

POTATOES 

Composition  and  Food  Value 219 

Methods  of  Preparation 221 

Reactions 222 

Indications  and  Contraindications 223 

Changes 226 

Farinaceous  Foods  and  Legumes  in  Early  Infancy 226 

GREEN   VEGETABLES 

Composition  and  Food  Value 234 

Methods  of  Preparation 237 

Reactions   239 

Indications  and  Contraindications 241 

Particulars 245 

Sprouts  and  Bulbs 245 

Roots  and  Beets 249 

Herbaceous   Vegetables 251 

Vegetable  Fruits 253 

Mushrooms . .  .  254 


TABLE   OF  CONTENTS  xv 


FRUITS 

PAGE 

Aqueous,  Acidulated 257 

Composition — Alimentary  Value 257 

Methods  of  Preparation 260 

Reactions 262 

Indications  and  Contraindications 264 

Particulars  and  Characteristics 269 

Saccharine  and  Neutral  Fruits 278 

Oily  Fruits 279 

CONDIMENTS— SPICES 

Salt 283 

Sugar 288 

Other  Condiments . .  .292 


NERVE    FOODS 

Coffee 295 

Tea 301 

Cocoa..  .  304 


BEVERAGES 

Water 308 

Alcoholic  Beverages 316 

Alcohol 317 

Liqueurs 323 

Wines 327 

Beer 337 

Cider 342 

VEGETARIANISM— FRTJITARIANISM 

Adherents  and  Tenets  of  Vegetarianism 344 


xvi  TABLE   OF  CONTENTS 

PAGE 

COMPARATIVE  TABLE  OF  ALIMENTARY  PROPORTIONS 360 

GLOSSARY — Definitions  of  Technical  Terms  Employed  in  the 
Text 363 

ANALYTICAL  TABLE  OF  DISEASES  REFERRED  TO  IN  THE 
TEXT 369 

WEIGHTS  AND  MEASURES 371 

INDEX..  .  373 


WHAT  SHALL  I   EAT? 


INTRODUCTION 

LIFE,  by  its  chemicophysical  actions,  produces 
throughout  the  whole  organism  an  incessant 
flow  of  cellular  changes.  The  living  cell  uses 
itself  up,  as  it  were,  and  incessantly  casts  off 
certain  elements  which  are  not  in  consonance 
with  its  proper  functions,  deriving  its  heat  and 
energy  from  the  combustion  of  organic  matter 
that  reaches  it  in  the  ordinary  way  and  through 
the  proper  channels.  Wear  and  tear  and  com- 
bustion is  the  never-ending  process  of  decompo- 
sition, or  catabolism,  which  must  of  necessity  be 
compensated  by  a  parallel  process,  or,  in  other 
words,  by  corresponding  acts  of  assimilation,  i.  e. , 
metabolism.  Thus  life  is  determined  by  a  dou- 
ble action,  i.e.,  absorption  and  decomposition. 
The  organic  equilibrium  or  balance  is  estab- 
lished by  the  proportion  that  exists  between  the 
two. 

Alimentation  renders  assimilation  possible  by 
adducing  the  requisite  material  in  an  appropri- 
ate form.  Every  substance  which  the  organism 

3 


4  WHAT   SHALL   I    EAT? 

is  able  to  assimilate  is  food,  no  matter  whether 
it  is  used  for  the  purpose  of  reconstituting  the 
wasted  tissues,  or  to  recover  the  losses  in  cal- 
ories. If  we  adopt  this  general  definition,  then 
oxygen  is  food — in  fact,  the  most  important  food 
of  all.  But  in  general  practice  the  term  "food" 
is  applied  only  to  those  substances  which  pass 
by  ingestion  through  the  alimentary  canal. 

Food  is,  therefore,  the  condition  of  life  of  the 
organism,  but  becomes  a  harmful  element  when 
it  departs  from  its  physiological  functions. 

In  former  days  the  opinion  prevailed  that 
food  might  either  act  as  an  aid  or  as  a  foe  in  ev- 
ery disease.  Modern  science,  however,  claims 
that  food  has  an  enormous  influence  on  the  well- 
being  of  the  human  race  in  general  as  well  as  on 
the  individual;  that  the  origin  of  many  morbid 
conditions  can  be  traced  to  a  faulty  regimen, 
and  that  rational  feeding  is  the  fundamental 
condition  of  our  physical  health. 

In  primitive  times  the  physiological  instinct 
inherent  in  man  served  as  a  guide  in  the  choice 
of  quality  as  well  as  quantity  of  food.  This 
has  changed  but  little  in  our  days.  Individual 
greediness,  encouraged  by  a  culinary  art  at  once 
complicated  and  ill-advised,  and  the  exigencies 


INTRODUCTION  5 

of  modern  life  which  force  upon  man  the  im- 
moderate use  of  alcoholic  and  other  stimulating 
substances,  undoubtedly  lead  to  an  anti-hygienic, 
irritating,  and  too  copious  employment  of  food. 
At  the  same  time  the  unrestricted  influx  of  pop- 
ulation into  large  cities  and  the  difficulties  en- 
countered in  provisioning  the  same,  largely  af- 
fect the  food  question,  often  enough  indeed  to 
the  extent  of  downright  wickedness  and  knavery. 

Against  these  evil  tendencies — becoming  more 
pronounced  every  day — a  certain  current  of  re- 
action has  set  in  with  the  avowed  purpose  of 
providing  a  pure  food  supply  based  upon  the  ra- 
tional principles  of  physiology.  This  movement 
might  be  summed  up  in  the  following  axiom: 
"  Rational  feeding  must,  while  pleasing  to  the 
palate,  maintain  the  physical  balance,  equip  the 
organs  with  comfort,  and  reduce  to  a  minimum 
the  fatigue  engendered  by  its  ingestion. ' ' 

In  order  to  establish  a  proper  basis  in  this 
connection,  it  is  primarily  necessary  to  fully  un- 
derstand the  two  conditions  by  which  the  physi- 
cal balance  is  maintained,  i.e.,  fixed  principles 
or  the  material  for  up-building,  and  calories  or 
material  for  combustion.  It  is  easy  to  deter- 
mine the  former,  because  the  renal,  intestinal, 


6  WHAT  SHALL   I    EAT? 

pulmonary,  and  cutaneous  eliminations  establish 
their  limits.  We  mention,  first  of  all,  water,  of 
which  we  excrete  more  than  2,400  cubic  centi- 
meters per  day.  Then  there  is  nitrogen,  which, 
either  under  the  form  of  urea,  or  of  purins,  or 
amino  acids,  amounts  to  about  15  grams  (an 
equivalent  of  about  100  grams  of  albumin). 
Finally,  we  must  consider  the  inorganic  sub- 
stances, viz.:  salt  (sodium  chlorid),  11  to  12 
grams;  phosphates,  4  to  5  grams,  allied  either 
with  alkaline  or  earthy  basic  substances;  sul- 
phates, 3  to  4  grams;  carbonates  or  bodies,  such 
as  lime,  0. 50  gram ;  magnesium,  0. 20  centigram ; 
soda,  1.50  grams;  potash,  0.40  centigram;  iron, 
0.02  to  0.04  centigram;  and  a  whole  series  of 
other  substances  present  perhaps  in  negligible 
quantities  only,  yet,  nevertheless  of  appreci- 
able physiological  importance;  we  quote  iodid, 
arsenic,  manganese,  fluorin,  bromin,  etc. 

The  daily  percentage  of  water  and  nitrogen  is 
nearly  always  sufficiently  large.  Nitrogen,  in- 
deed, is  believed  to  sin  by  excess  rather  than  by 
default.  The  mineral  bodies  are  never  present 
to  the  same  extent.  We  shall,  therefore,  exer- 
cise particular  care  in  giving  the  mineral  value 
of  each  food  mentioned.  As  for  the  rarer  bod- 


INTRODUCTION  7 

ies,  such  as  iodid,  arsenic,  and  manganese,  they 
are  found  only  in  a  small  number  of  foodstuffs, 
chiefly  in  vegetables.  In  order  to  obtain  them 
it  is  necessary  to  change  the  diet  constantly. 

It  is  much  more  difficult  to  calculate  the  re- 
quirements of  energy,  of  the  calories.  It  entails 
untold  labor,  though  at  the  present  hour  the 
question  seems  to  have  been  pretty  [definitely 
settled.  Pettenkofer  and  Voit  made  a  series  of 
very  successful  experiments  with  men  in  prime 
condition;  A.  Gautier  calculated  the  amount  of 
food  consumed  in  Paris  from  1890  to  1899;  At- 
water  figured  out,  in  his  calorimetric  labora- 
tories, the  number  of  calories  emitted  in  twenty- 
four  hours  by  a  man  in  a  state  of  perfect  health. 
The  results  obtained  in  all  these  instances  were 
approximately  the  same  and  allow  of  the  follow- 
ing conclusion: 

The  mean  ratip  in  the  adult  in  a  moderate  cli- 
mate is  thirty -eight  calories  per  kilogram  per 
day. 

For  several  years  Drs.  Pascault,  Fauvel,  and 
Labbe  have  demonstrated  that  even  a  notably 
smaller  ratio  is  quite  compatible  with  even  a 
very  active  life.  It  seems  to  us,  however,  that 
these  statements,  although  they  are  interesting 


8  WHAT   SHALL   I    EAT? 

from  the  standpoint  of  pathology  and  in  cases 
in  which  a  restriction  of  diet  is  indicated,  for 
instance  in  arthritis,  are  not  applicable  in  the 
domain  of  physiology  or  to  normal  health.  We 
feel  rather  inclined  to  modify  the  axiom  quoted 
above  and  put  it  in  this  way: 

We  can,  if  needs  be  and  the  interests  of  health 
so  require  it,  decrease  the  mean  ratio  to  thirty 
calories — and  even  below  this — per  kilogram  per 
day,  so  long  as  this  is  done  under  the  careful 
surveillance  of  a  physician. 

Of  course  this  law  of  ratio  is  modified  by 
many  circumstances.  It  is  too  low  for  heavy 
weights  and  men  of  big  stature,  and  vice  versa. 

That  it  is  too  high  for  children  under  fifteen 
years  of  age  goes  without  saying.  In  sick  peo- 
ple twenty-five  to  thirty  calories  are  rather 
indicated,  except  in  special  cases,  such  as  con- 
sumption. For  the  more  important  exemptions 
we  refer  the  reader  to  special  treatises  on  the 
subject,  preferably  to  that  excellent  work  by  A. 
Gautier *  from  which  we  shall  have  frequent  op- 
portunity to  quote. 

The  calories  are  produced  by  the  combustion 


'A.    Gautier:     "L'alimentation    et    les    regimes,"    Paris, 
Masson. 


INTRODUCTION  9 

of  the  food.  Two  principles  must  be  here  main- 
tained: 1.  Food  develops  in  the  human  body 
exactly  the  same  amount  of  heat  as  it  does  in 
the  incubator  of  the  chemist.1  2.  In  the  sus- 
tenance of  life  no  energy  is  consumed  which 
properly  belongs  to  it.  —  (Berthelot.)  All  energy 
utilized  by  the  living  organism  is  derived  from 
the  food  and  from  the  tissue  itself. 

It  is  simple  enough  to  calculate  the  heat  pro- 
duced by  the  combustion  of  each  foodstuff.  We 
will  classify  the  substances  which  serve  as  nutri- 
ents for  our  body  into  four  divisions,  viz. :  the 
albuminoids,  which  include  all  nitrogenous  sub- 
stances; fats;  carbohydrates;  and  inorganic  mat- 
ter (ash) — the  latter  is  completely  oxidized  and 
of  no  calorific  value.  The  others  are  each  its 
own  special  coefficient. 

1  gram  of  albumin  gives  when  burned  4  calories 4 

1  gram  of  fat  gives  when  burned  9  calories 4 

1  gram  of  carbohydrate  gives  when  burned  4  calories.    1 

Now,  if  we  know  the  composition  of  a  certain 
article  of  food  it  will  be  easy  to  compute  the 
number  of  calories  obtained  from  it. 

"We  must  not  forget,  however,  that  a  part  of 

1  Always  on  the  condition  that  the  final  state  of  the  residue 
be  the  same  in  both  cases. 


10  WHAT  SHALL   I    EAT? 

all  that  we  consume  is  lost  within  us  and  passes 
through  the  alimentary  canal  without  being 
absorbed.  We  shall  keep  an  account  of  this 
factor,  i.e.,  intestinal  non-absorption.  The  fig- 
ures which  we  shall  give  for  each  food  will  cor- 
respond not  with  that  which  enters  through  the 
mouth,  but  with  what  passes  the  intestinal  bar- 
rier— in  other  words  they  refer  not  to  the  sub- 
stances ingested,  but  to  the  substances  digested 
and  utilized  by  the  organism.1 

We  have  thus  briefly  described  the  laws  gov- 
erning the  general  fixed  principles  as  well  as  en- 
ergy itself.  To  this  the  labors  of  the  hygienist 
would  be  confined  if  the  problem  of  nutrition 
were  not  strangely  complicated  by  a  new  factor 
of  the  utmost  importance,  which  controls  the 
whole  system  of  the  physiopathology  of  nutri- 
tion, viz. :  alimentary  reactions.  The  human 
body  is  a  machine  so  delicate,  so  sensitive,  that 
it  reacts  immediately,  and  in  a  manner  of  its 
own,  to  every  substance  which  enters  it  through 
the  tube.  Each  food  acts  in  its  own  fashion  on 
all  the  cells  and  on  all  the  organs  composed  of 
these  cells.  Reaction  exists  by  necessity,  no 

'This  has  been  rendered  easy  by  the  excellent  tables  so 
carefully  prepared  by  d'Alquier. 


INTRODUCTION  11 

matter  how  insignificant  it  may  be  in  itself,  no 
matter  whether  it  has  as  yet  escaped  the  investi- 
gations of  the  physiologist.  If  we  take  into 
consideration  that  ingestion  takes  place  two  or 
three  times  a  day,  we  can  easily  understand 
what  a  weighty  influence  it  exerts  on  the  func- 
tions of  the  organs. 

The  reaction  of  food  may  be  considered  from 
three  different  standpoints:  a,  every  food  must 
be  prepared  and  digested  before  it  can  be  util- 
ized by  the  cellular  system,  and  then  only  does 
it  possess  the  power  of  digestive  reaction;  b, 
every  food  is  a  source  of  energy,  which  gives  a 
special  impetus  to  the  life  of  all  the  cells,  and 
as  such  it  exerts  a  general  reaction;  c,  every 
food  leaves  a  waste,  of  which  the  system  must 
needs  rid  itself,  and  as  such  its  reaction  is  elim- 
inatory. 

The  digestive  reaction  is  the  strongest  in  evi- 
dence, but  the  least  understood;  again,  the  sub- 
stances which  require  the  smallest  amount  of 
digestion,  such  as  water,  salt,  glucose,  etc., 
modify,  by  their  very  presence,  the  physical  and 
chemical  equilibrium  of  the  gastrointestinal 
canal.  According  to  natural  laws  the  greater 
part  of  the  food  is  digested,  and  then  it  possesses 


12  WHAT   SHALL   I    EAT? 

a  twofold  coefficient  of  excitation,  i.  e. ,  glandu- 
lar on  the  one  hand  and  muscular  on  the  other. 
The  equilibrium  which  establishes  itself  auto- 
matically between  these  stimulations,  be  they 
strong  or  feeble,  results  in  the  harmonious  and 
normal  functions  of  the  digestive  apparatus, 
i.e.,  in  secretions  and  peristalsis. 

The  ultimate  general  effects  are  sensibly  more 
complex  and  present  much  of  the  unknown. 
The  principles  of  alimentation  produce  a  com- 
bined action  upon  the  nutritive  movements 
of  the  entire  organism.  Pascault  very  tritely 
says:  "Life  springs  from  an  exciting  cause  and 
continues  to  subsist  on  it.  The  living  cell  passes 
from  the  dormant  state  into  that  of  activity, 
having  been  called  into  existence  by  a  demand 
coming  from  within. ' ' l 

The  excitations  which  we  draw  from  the  am- 
bient center,  emanate  largely  from  the  food 
which  we  ingest.  Some  foods  have  a  much 
higher  stimulating  power  than  others.  They 
accelerate  nutrition,  cost  more,  but  give  a  dou- 
ble measure  of  life.  Others  possess  only  a  very 
indifferent  amount  of  stimulation  and  rather  re- 
tard the  cellular  action,  but  make  the  living  less 
'Pascault:  "L'arthritism  par  suralimentation. " 


INTRODUCTION  13 

expensive.  Both  are  useful,  on  the  supposition 
that  they  compensate  each  other,  and  that  es- 
tablishes a  balance  for  maintaining  the  nutritive 
function  on  a  physiological  level.  Apart  from 
this  general  reaction  which  addresses  itself  pri- 
marily to  each  individual  cell,  food  effects  also  a 
specialized  reaction  on  each  organ,  nay,  on  each 
function  thereof.  Some  of  these  are  well  under- 
stood; for  instance,  the  action  of  beef -tea  on  the 
heart,  of  coffee  on  the  brain,  of  sugar  on  the 
liver.  Much,  however,  is  still  shrouded  in  mys- 
tery, and  in  this  regard  the  task  in  front  of 
physiological  research  is  still  very  exacting. 

Finally,  the  combustion  of  any  food  leaves 
behind  certain  residues,  such  as  water,  carbonic 
acid,  inorganic  salts,  urea,  uric  acid,  etc.,  which 
must  be  cast  off  in  proper  proportions  and 
through  the  proper  channels.  Carbonic  acid 
finds  its  escape  through  the  lungs;  other  ele- 
ments are  eliminated  through  the  kidneys,  still 
others  through  the  bowels,  and  some  through 
the  skin. 

Even  a  hasty  review  of  the  albuminoids,  of 
the  fats,  and  the  carbohydrates,  throws  much 
light  upon  this  subject.  Nitrogen  intensely 
stimulates  the  digestive  organs,  glandular  as 


14 

well  as  muscular;  but  its  action  is  of  short  dura- 
tion and  of  no  lasting  value.  Fat,  on  the  con- 
trary, owing  to  its  retarding  action,  tempers  the 
excitations  aroused  by  preceding  influences; 
while  the  carbohydrates  slightly  fatigue  the 
stomach;  but  they  impart  tone  to  digestion  and 
prolong  its  action,  thus  facilitating  the  absorp- 
tion of  albumin  and  fats. 

The  general  reaction  differs  not  from  this. 
Nitrogen  here  also  acts  as  a  stimulant  by  aug- 
menting the  activity  of  the  organism.  Fat, 
however,  exercises  an  inhibiting  influence  which 
diminishes  disassimilation,  chiefly  that  of  nitro- 
gen. This  selfsame  retarding  action  is  also  very 
markedly  observed  in  the  carbohydrates  which 
rather  direct  albumin  and  fats  to  the  liver. 

Resistance  is  very  pronounced  in  the  kidneys, 
because  the  ternary  bodies,  by  reason  of  perfect 
combustion,  leave  but  water  and  carbonic  acid 
behind,  while  the  nitrogenous  residues  engage 
exclusively  the  renal  glands,  often  enough  to 
the  latter 's  discomfort  and  detriment. 

A  judicious  proportion  in  their  relative  func- 
tions, in  accordance  to  the  physiological  laws, 
may  be  observed  in  these  three  fundamental 
bodies.  The  calculations  made  in  this  direction 


INTRODUCTION  15 

are  based  entirely  upon  experiments  made  with 
due  care  and  diligence. 

IN   THE   ADULT. 

Albumin  present 18.1  per  cent. 

Fat  present 10.4  per  cent. 

Carbohydrates  present.  .  .      71.5  per  cent. 

Grand  total 100.0 

Now  taking  into  account  the  isodynamic  co- 
efficient and  the  total  amount  of  calories  re- 
quired, we  derive  the  following  formula  for  the 
daily  ratio  in  a  man  weighing  about  one  hun- 
dred and  thirty-five  pounds: 

Albumin 96  grams 

Fats 55  grams 

Carbohydrates 379  grams 

These  alimentary  reactions  represent  the  sa- 
lient feature  of  the  problem  before  us.  They 
must  ultimately  determine  our  knowledge  as  to 
whether  our  method  of  feeding  is  built  upon 
hygienic  and  rational  principles  or  not,  or,  in 
other  words,  whether  by  filling  our  daily  wants, 
we  also  afford  such  comfort  to  our  organs  as  is 
compatible  with  the  minimum  amount  of  fa- 
tigue in  the  performance  of  their  functions. 


16  WHAT  SHALL   I    EAT? 

The  exhaustive  researches  which  are  nowadays 
being  made  in  this  branch  of  medical  science 
have  for  their  object  the  establishment  of  pre- 
cise laws  and  regulations  affecting  the  hygiene 
and  methods  of  nutrition.  These  will,  natu- 
rally, occupy  a  prominent  part  in  this  book,  the 
aim  of  which  is  to  present,  in  a  concise  manner 
and  so  far  as  can  be  done,  the  good  and  evil 
effect  on  our  system  of  everything  that  is  placed 
before  us  on  the  table  in  the  shape  of  food  or 
drink. 

We  know  well  enough  that,  as  a  rule,  the 
man  who  is  in  good  health  troubles  himself 
but  little  about  what  he  eats.  While  we  appre- 
ciate that,  from  the  general  standpoint,  he  can 
and  should  be  able  to  eat  anything  and  every- 
thing that  is  eatable,  yet  we  think  that  his  diet 
should  be  so  arranged  that,  so  far  as  the  limits 
and  proportions  which  we  intend  to  define  are 
concerned,  it  should  offer  a  variety  sufficiently 
large  for  all  purposes  without  giving  undue 
preference  to  one  or  any.  We  shall  take  occa- 
sion, in  its  proper  place,  to  point  out  certain 
useful  details  in  the  choice  of  foods  adapted 
to  the  needs  and  requirements  of  individual 
cases. 


INTRODUCTION  17 

The  medical  man  should  never  lose  sight  of 
the  paramount  importance  of  dietetics  in  every 
illness,  especially  of  the  alimentary  reactions. 
The  functional  troubles  which  father  a  patho- 
logical condition,  more  so  than  any  anatomical 
lesion  will  do,  demand  of  necessity  the  utmost 
circumspection  and  prudence  in  the  selection  of 
food,  as  to  its  nature  as  well  as  to  its  quality. 
Forbidden  should  be  everything  that,  by  its 
action,  is  calculated  to  give  aid  to  the  further 
development  of  the  germs  of  the  disease,  but 
recommended  all  such  as  will  neutralize,  mod- 
ify, or  destroy  them.  Always  bear  in  mind  that 
there  are  diseases  which  are  entirely,  or  at  least 
in  part,  due  to  and  arise  from  a  faulty  diet. 
These  should  be  combated  by  diet  only. 

However,  this  specific  field  of  therapeutics  has 
a  vast  and  complex  compass.  To  facilitate  its 
study,  we  shall  present  a  review,  as  it  were,  of 
all  the  foods  in  common  use,  somewhat  in  the 
fashion  of  a  dictionary,  quoting  for  each  indica- 
tions and  contraindications. 

The  chemical  composition  will  be  followed  by 
a  discussion  of  the  food  value,  and  then  the  re- 
actions which  explain  and  justify  the  same  will 
be  dealt  with. 


18  WHAT  SHALL   I    EAT? 

We  apologize  in  advance  for  any  repetitions 
which  will  unavoidably  occur  in  a  book  like 
this.  They  appear  to  be  useful,  for  they  make 
the  book  handy  and  easy  to  consult. 


MEAT 

BUTCHER'S   MEAT 

MEAT,  composed  of  the  muscular  flesh  of  the 
vertebrates,  has  constituted  in  nearly  all  ages  a 
principal  part  of  the  food  of  mankind.  During 
our  time,  under  the  influence  of  improved  con- 
ditions and  the  accommodations  of  the  market, 
its  consumption  has  increased  in  astonishing  pro- 
portions. If  it  has  entered  into  the  diet  of  the 
workman  and  peasant  as  an  ordinary  matter,  it 
has  assumed  an  exaggerated  importance  on  the 
table  of  the  wealthy.  From  1852  to  1900  the 
yearly  consumption  per  head  has  progressed  (in 
France)  from  42  to  79  pounds.  This  increase, 
which  witnesses  to  a  growth  of  wealth,  is  in  all 
probability  not  equally  favorable  from  an  hy- 
gienic point  of  view.  The  meat  diet  encounters 
daily  an  ever-growing  number  of  adversaries, 
and  there  is  no  food  that  gives  rise  to  more 
varied  and  more  interesting  problems. 

We  shall  study  these  problems  more  exhaus- 


20  WHAT  SHALL   I    EAT? 

tively  with  regard  to  beef,  which  may  be  taken 
as  a  typical  element  of  animal  food.  As  for  the 
other  kinds  of  meat,  we  will  go  only  into  such 
details  as  distinguish  them  from  the  former. 

BEEF 

Albumin  .....................  18.00 

Fats  ........................  14.00 

Carbohydrates   ................  0.00 

Ash  .........................  0.72 

Chlorids  .....................  0.06 

Purins1  ......................  0.19 

Available  calories  = 


COMPOSITION    AND   ALIMENTARY   VALUE 

The  essential  characteristic  of  beef  is  its  rich- 
ness in  nitrogen,  only  exceeded  in  cheese.  The 
proportion  of  nitrogen,  however,  varies  consid- 
erably according  to  the  individual  animal  as 
well  as  to  the  cut.  The  fatter  the  animal,  the 
smaller  the  percentage  of  nitrogen.  The  shoul- 
der is  the  poorest  cut,  while  the  ribs  of  beef,  sir- 
loin, and  rump  belong  to  the  richest  and  most 
savory  pieces. 

The  figures  given  at  the  head  of  this  chapter 
represent  only  the  mean  average. 

1  The  purins  (puric  bodies)  always  have  reference  to  uric  acid. 


MEAT  21 

The  nitrogen  is  composed  of  albuminoids,  i.  e. , 
myosin,  myostroin,  myoalbumin,  and  partly  of 
extractive  substances  belonging  to  the  family  of 
xanthic  bodies. 

These  xanthic,  or  puric  bodies,  though  small  in 
quantity,  are  yet  of  such  importance  as  regards 
quality,  that,  for  certain  diseases,  foods  may 
be  divided  into  two  categories,  viz. :  those  con- 
taining xanthic  bases,  and  those  that  are  free 
from  them.  A  few  words  on  this  subject, 
no  doubt,  will  be  considered  opportune  by  the 
reader. 

Xanthic  bodies  or  bases,  or  puric  bodies  or 
bases,  comprise  a  number  of  substances  which 
are  commonly  derived  from  nuclein  and  possess 
the  nuclein  of  purin.  —  (Fischer.)  These  sub- 
stances are  principally  guanin,  adenin,  hypo- 
xanthin,  xanthin,  and  uric  acid.  By  oxidation 
guanin  becomes  xanthin,  and  the  latter  is 
turned  into  uric  acid.  In  a  similar  fashion  by 
oxidation  adenin  gives  hypoxanthin,  and  this 
again  gives  xanthin,  and  this  in  its  turn 
again  uric  acid.  Uric  acid,  therefore,  is  chiefly 
derived  by  oxidation  from  the  xanthic  bases 
which  are  contained  in  the  urine  in  small  quan- 
tities. The  derivation  of  the  xanthic  bases 


22  WHAT  SHALL   I    EAT? 

from    nuclein    is   schematized  in  the  following 
sketch. 


toolein,. 


cleio  Aoil. 


Albumin. 


P  0*  H Carbohydrates': Xanthio  BasesT   Thymin 


Recent  research  has  proved  that  urinary  pu- 
rins  spring  from  two  sources.  Endogenetic  purin 
is  produced  by  the  rejection  of  nuclein  by  the 
organism;  its  percentage,  though  variable  in 
each  individual,  is  a  fixed  quantity  in  each  indi- 
vidual. Exogenetic  purin,  of  alimentary  origin, 
varies  considerably  according  to  diet,  and  may 
be  reduced  to  zero  by  a  regimen  entirely  free  of 
all  xanthic  bodies. 

The  nitrogen  of  beef  contains  also  collage- 
nous,  membranous  substances,  that  boiling 
transforms  into  gelatin.  Fat  varies  in  inverse 
ratio  to  albumin,  but  in  much  stronger  propor- 
tion, changing  sometimes  from  1  to  3.  It  lends 
to  meat  much  of  its  taste  and  savory  flavor. 

The  carbohydrates  are  either  totally  absent  or 
represented  only  by  traces  of  glycogen. 

The  mineral  principles   are  relatively   insig- 


MEAT  23 

nificant,  for  beef  is  not  a  mineral  food.  We  em- 
phasize the  scarcity  of  chlorid  of  sodium  (salt), 
which  fact  puts  meat  in  the  class  of  dechlorated 
nutriments.  On  the  other  hand  the  supera- 
bundance of  phosphates  explains  the  frequent 
occurrence  of  phosphaturia,  due  to  the  excessive 
use  of  animal  foodstuffs.  Beef  is  a  powerful 
factor  in  humoral  hyperacidity. 

Its  alimentary  value,  which  depends  almost 
wholly  on  the  percentage  of  fats  present  in  it,  is 
rather  slight.  It  takes  only  second  place  to  but- 
ter, sugar,  bread,  rice,  and  pulse.  Moreover, 
nearly  half  of  its  calories  are  derived  from  al- 
bumin which  itself  is  very  inferior  in  producing 
energy.  If  to  that  the  high  cost  of  meat  is 
added,  it  is  hard  to  understand  why  beef  should 
be  held  in  such  high  repute  as  a  table  food.  Its 
sole  merit,  from  the  alimentary  standpoint,  can 
only  be,  that  it  supplies  within  a  small  compass 
a  comparatively  large  amount  of  assimilable  ni- 
trogen. 

METHODS    OF    PREPARATION 

Mankind  very  early  formed  the  habit  of  cook- 
ing meat.  Raw  meat  is  nowadays  used  only  as 
a  sort  of  remedy,  more  or  less  acceptable  accord- 
ing to  the  taste  and  liking  of  sick  or  ailing  peo- 


24  WHAT   SHALL   I    EAT? 

pie.  Richet's  research  on  its  efficacy  in  tuber- 
culosis has  given  it,  nevertheless,  a  fresh  claim 
on  importance.  He  quotes  the  following  recipe: 
An  absolutely  fresh  piece  of  a  prime  cut  is  se- 
lected, it  should  be  as  far  as  possible  without 
tendons.  It  is  scraped  with  a  knife,  which  de- 
taches the  pulp,  and  this  is  rolled  up  into  balls 
that  the  patient  swallows  without  masticating. 
It  may  also  be  served  in  warm  bouillon  or  cov- 
ered with  powdered  sugar.  [Why  not  coated 
with  the  white  of  a  fresh  raw  egg?  —  Trans- 
lator. ] 

Aside  from  this  exception  muscular  flesh  is 
subjected  nearly  always  to  the  action  of  fire, 
which  develops  its  flavor.  It  is  in  this  way, 
perhaps,  a  little  less  digestible,  but  it  excites 
more  thoroughly  the  gastric  excretions  and  has 
stronger  powers  for  reconstruction.  —  (Richet ) 

The  different  methods  of  preparation  affect 
its  physicochemical  qualities  more  or  less  favor- 
ably. 

Boiled,  the  beef  imparts  to  the  water  in  which 
it  is  cooked  a  certain  quantity  of  albumin,  on 
the  average  7  per  cent,  a  great  deal  of  fat,  i.e., 
20  per  cent,  of  which  a  goodly  portion  is  unfor- 
tunately lost  in  skimming,  and  much  of  the 


MEAT  25 

mineral  salts.  The  nutritive  value  of  the  beef 
would  thus  be  much  diminished,  if  it  were  not 
sustaining  at  the  same  time  a  concentration  of 
nearly  40  per  cent,  which  maintains  the  ratio 
of  nutrition  very  effectively.  Boiled  beef,  it  is 
true,  is  more  nitrogenous,  but,  on  the  other 
hand,  it  is  impoverished  in  fats,  demineralized, 
more  insipid,  and  withal  heavier  on  the  stomach. 
We  point  out,  however,  that  if  kitchen  salt  is 
added  while  the  soup  is  boiling,  a  large  part  of 
the  chlorids  will  pass  into  the  meat. 

In  roast  beef  a  crust  is  formed  on  the  surface, 
which  greatly  diminishes  waste.  A  moderate 
roasting  occasions  a  loss  of  only  10  to  12  per 
cent  of  water,  2  to  3  per  cent  of  nitrogen,  and 
10  to  12  per  cent  of  mineral  matter.  The  loss 
in  fat,  however,  is  much  greater,  the  average 
being  35  per  cent.  Of  course  this  entails  an 
impairment  of  nutritive  value;  but  by  compen- 
sation, as  it  were,  the  development  of  the  flavors 
attains  its  highest  degree,  and  makes  roast  beef 
the  more  savory  and  the  more  stimulating  for 
the  stomach.  Stewed  meat,  cooked  in  the  pan 
in  fat,  becomes  more  concentrated  through 
evaporation,  but  the  loss  in  nitrogen  is  small, 
likewise  that  of  mineral  matters,  2  to  3  per 


26  WHAT  SHALL   I    EAT? 

cent,  but  is  almost  surfeited  with  fat  to  the 
detriment  of  the  ambient  center.  It  is  more 
nourishing,  but  also  heavier  and  less  digestible. 
Excluding  these  methods  of  preparation  the  dif- 
ferent sauces  and  gravies  tend  again  to  change 
and  modify  the  nutritive  value  as  well  as  the 
digestibility  of  the  meat.  In  a  general  way  all 
sauces  containing  butter  or  warm  fats,  all  brown 
butter  sauces  and  ragouts,  etc.,  are  bad.  The 
white  and  piquant  sauces  also  belong  to  this 
same  category.  On  the  other  hand,  meat  cooked 
in  its  own  juice,  according  to  the  custom  of 
olden  times  (baked  beef  and  beef  a  la  mode), 
are  foods  good  for  the  stomach  and  hygienic  in 
a  general  way — it  is  meat  which  has  not  lost 
any  of  its  nutritive  principles,  but  remains  suffi- 
ciently salty  without  overstimulating  the  appe- 
tite or  causing  the  inconveniences  that  follow  in 
the  wake  of  surfeit. 

A  practice  that  can  be  recommended  is  to 
garnish  the  meat  either  with  green  vegetables, 
or,  better  still,  with  potatoes  in  any  form  or 
with  dumplings  or  other  farinaceous  prepara- 
tions. In  this  manner  its  deficiency  in  carbo- 
hydrates may  also  be  compensated.  Moreover, 
it  adds  variety  and  change  to  the  diet  and 


MEAT  27 

excludes  all  excuses  for  overindulgence  in  bread, 
so  common  with  many  persons. 

REACTIONS 

A.  Digestive. — Meat  is  essentially  a  stimu- 
lant of  gastric  secretion,  in  fact  the  most  stimu- 
lating of  all  foods.  It  possesses  a  psychic  action 
by  means  of  its  odors  and  aroma,  and  a  chemi- 
cal action  through  its  extractive  substances. — 
(Pauloff. )  We  shall  endeavor  to  show  how  the 
methods  of  preparation  affect  the  stimulating 
qualities. 

The  degree  to  which  the  meat  is  cooked  gov- 
erns the  length  of  time  required  for  its  passage 
through  the  stomach.  The  closer  the  fiber,  the 
longer  it  remains.  A  slice  of  roast  beef  is  di' 
gested  only  at  the  end  of  three  to  four  hours. 

The  stimulation  extends  also  to  the  bowels,  to 
the  pancreas,  and  to  the  liver,  and  thus  affects 
the  general  tone  of  the  whole  system.  But  this 
period  of  excitation  does  not  last  long  and  is 
soon  followed  by  a  passus  of  depression,  the  in- 
tensity of  which  is  in  direct  proportion  to  the 
degree  of  excitation.  However,  it  is  complete, 
for  meat  leaves  no  residue. 

Meat  justly  deserves  the  title  of  "gastric  ali- 


28  WHAT  SHALL   I    EAT? 

ment, "  in  contradistinction  to  pulse  and  fruit, 
which  are  foods  for  intestinal  digestion.  This 
accounts  for  the  fact  that  heavy  meat-eaters  at 
first  experience  a  sensation  of  comfort,  but  soon 
begin  to  feel  uneasy  and  sluggish,  with  a  craving 
for  more,  i.e.,  renewed  stimulation.  Meat  has 
no  staying  power,  and  leads  to  overeating  and 
gluttony. 

We  have  already  stated  that  meat  leaves  no 
residue.  That  is  the  reason  why  an  animal  diet 
often  is  the  cause  for  constipation  and  stasis, 
particularly  in  the  large  intestine.  Although 
this  is  generally  known,  we  yet  consider  it  of 
such  importance  as  to  warrant  us  in  giving  it 
special  mention  here. 

Meat  also  encourages  the  formation  of  micro- 
organisms in  the  canal  and  furthers  putrefac- 
tion. Combe  was  among  the  first  to  show  that 
the  amount  of  sulphoether  in  the  urine,  the 
evidence  of  this  putrefaction,  is  increased  or  di- 
minished in  proportion  to  the  amount  of  meat 
consumed.  His  contention  is  sustained  by  many 
authorities.  The  excessive  use  of  meat,  it  is 
claimed,  gradually  affects  the  intestinal  flora  by 
intensifying  its  virulence,  changing  its  composi- 
tion, and  breeding  enterocolitis  and  appendi- 


MEAT  29 

citis.  It  is  now  generally  recognized  that  ni- 
trogen forms  a  splendid  breeding- ground  for 
intestinal  bacteria,  and  that  constipation  helps 
to  develop  them. 

Resume. — Meat  imposes  upon  the  gastric 
muscles  a  slow  process  of  activity,  but  vividly 
stimulates  the  glands  of  the  stomach  for  useful 
purposes,  whilst  its  action  on  the  intestines  is 
less  favorable,  because  its  excitation  is  of  too 
transient  a  nature;  the  absence  of  residue  inhib- 
its peristalsis,  and  the  extravagant  content  of 
nitrogen  forms  the  germination  of  microbes. 

B.  General. — The  reaction  of  the  meat  diet 
on  the  process  of  nutrition  in  general  can  be 
described  in  three  words:  it  excites,  it  acidifies, 
and  it  intoxicates. 

The  acceleration  of  organic  activity  following 
the  ingestion  of  meat  is  due  to  the  predomi- 
nance of  nitrogen  which  diminishes  the  power 
of  assimilation,  to  the  absence  of  carbohydrates, 
and  to  the  presence  of  extractive  substances. 

Under  moderate  circumstances  this  influence 
helps  to  maintain  the  general  tone  of  vitality: 
it  becomes  harmful,  however,  when  carried  to 
excess. 

Meat  acidifies  because  its  ash  is  acid,  because 


30  WHAT  SHALL   I    EAT? 

the  phosphoric  acid  contained  in  it  outweighs 
the  basic  substances,  and  also  because  its  com- 
bustion is  never  complete,  thus  giving  rise  to 
acids,  the  most  important  of  which  is  uric  acid. 
In  the  carnivorous  animals  these  acids  are  neu- 
tralized by  an  equivalent  production  of  am- 
monia; but  in  man  the  formation  of  ammonia 
is  very  limited,  and  with  an  increased  consump- 
tion of  animal  food  the  ratio  of  humoral  and 
urinary  acidity  rises  in  proportion. 

Meat  intoxicates  by  reason  of  its  basic  purins 
and  by  ptomains,  which  easily  become  most  nox- 
ious poisons  to  the  heart,  the  vessels,  and  to  the 
whole  organism,  though  they  are  of  indifferent 
value  when  present  in  a  small  volume.  More- 
over, the  bacterial  fermentations  due  to  meat 
are  of  a  toxic  nature.  Metschnikoff  points  out 
that  to  them  chiefly  is  due  premature  senility. 

To  know  the  action  of  meat  on  nutrition 
only  in  a  general  way,  does  not  suffice.  It  is 
of  the  utmost  interest  to  understand  the  influ- 
ence it  exerts  on  each  organ  in  particular.  The 
first  question  which  confronts  us  here  is:  In 
how  far  is  meat  necessary  or  useful  to  the  man 
who  performs  physical  labor,  and  to  him  who 
follows  mental  occupation? 


MEAT  31 

Albumin,  and  in  consequence  all  foods  of 
which  it  forms  the  basic  value,  cannot  furnish 
the  amount  of  calories  required  for  manual 
labor.  Bouchard  says:  "Meat  does  not  produce 
force."  This  function  belongs  to  the  ternary 
bodies.  Yet,  on  the  other  hand,  it  seems  to  be 
proved  that  meat  is  a  very  useful  article  for  the 
workman,  the  soldier,  and  the  athlete,  as  it  in- 
creases ability  for  work  in  the  production  of 
calories.  —  (Gautier.)  Take,  for  example,  the 
Anglo-Saxon  race.  They  are  heavy  meat-eaters 
and  excel  in  athletic  sports.  In  sum  total, 
meat  does  not  supply  power  for  physical  tasks, 
but  it  assists  in  accomplishing  them. 

It  is  quite  different  in  respect  to  mental  work. 
If  alcohol  and  tobacco  have  proved  themselves 
powerful  aids  to  the  author  in  rendering  his 
task  easy,  meat  has  never  offered  the  same  ad- 
vantage. How  often  do  not  writers  after  a 
heavy  meal,  especially  if  it  consists  largely  of 
animal  food,  complain  of  that  sluggish,  drowsy 
feeling  which  renders  them  incapable  of  accom- 
plishing anything.  At  the  Congress  for  Food 
and  Hygiene,  De  Fleury  insisted  that  meat  is 
not  an  aliment  fit  for  the  mind,  and  that  its  use 
does  more  harm  than  good. 


32  WHAT   SHALL   I    EAT? 

The  cardiovascular  system  is  likewise  affected 
by  a  meat  diet,  chiefly  by  reason  of  its  excess  in 
extractive  substances. 

The  pulse  grows  more  rapid  and  harder,  the 
tension  is  raised,  whilst  the  vasoperipheral  con- 
striction increases  the  heart's  action  and  predis- 
poses the  smaller  vessels  to  sclerosis. 

An  exaggerated  meat  diet  is  one  of  the  prin- 
cipal factors  in  hypertension  and  sclerosis. 

Hepatic  excitation  is  not  less  marked,  since 
uropoiesis,  the  neutralization  of  toxic  matter, 
imposes  upon  the  cellular  tissues  extra  labor. 
This  excitation,  which  at  first  is  limited  to  uro- 
poietic  tapping,  soon  invades  the  biliary  and 
glucogenic  functions  also. 

It  would  be  interesting  to  know  the  influence 
of  meat  on  the  development  and  functioning  of 
the  intestinal  secretory  glands — the  thyreoid1 
and  genital  glands,  and  the  suprarenal  capsules. 
As  the  functions  of  all  these  organs  are  anti- 
toxic, it  is  likely  that  the  use  of  muscular  meat 
entails  additional  activity,  but  precise  informa- 
tion on  this  subject  is  still  lacking. 

C.  Eliminatory. — The  ingestion  of  muscular 

1  According  to  Leopold  Levi  meat  is  poison  to  the  thyreoid 
glands. 


MEAT  33 

meat  reacts  strongly  on  the  kidneys.  If  urea, 
the  issue  of  albumin,  may  be  considered  in 
the  normal  state  as  a  diuretic,  its  elimination 
through  a  diseased  kidney  must  be  much  more 
laborious.  Uric  acid  and  the  xanthic  bodies  are 
substances  which  act  as  irritants  to  the  renal 
capsules  and  are  very  hard  to  eliminate,  and 
toxic  issues  from  the  intestines  add  still  more  to 
the  task  of  urinary  depuration.  Experiments 
made  by  Hanssen  prove  that  so  far  as  calorific 
value  is  concerned,  a  nitrogenous  diet  produces 
the  highest  molecular  elimination.  Achard  and 
Paisseau  claim  that  the  same  regimen  favors  the 
retention  of  chlorids.  All  this  leads  us  to  the 
conclusion  that  meat  has  no  favorable  effect  on 
the  functions  of  the  kidneys.  Nevertheless,  the 
question  is  rather  complex,  for  it  is  a  well- 
known  fact  that  meat  is  often  better  tolerated 
in  cases  of  nephritis,  than  one  would  be  led  to 
believe  by  this  theory. 

INDICATIONS   AND   CONTRAINDICATIONS 

Since  meat  is  easy  to  digest,  is  highly  nitro- 
genous and  stimulating,  it  should  form  a  part 
of  normal  alimentation,  especially  in  our  epoch 
of  strenuous  life  with  all  its  exacting  exigencies 


34  WHAT   SHALL   I    EAT? 

and  unforeseen  fatigues.  We  all  stand  in  need 
of  it — the  tiller  of  the  soil  as  well  as  the  toiler  in 
the  town.  But  if  the  rational  use  is  beneficial, 
the  abuse  is  equally  obnoxious,  and  the  daily 
ration  must  be  carefully  allotted.  For  the 
adult  of  an  average  weight  of  one  hundred  and 
forty-five  pounds,  150  to  200  grams  should  be 
an  ample  allowance.  Of  course  age  must  be 
taken  into  consideration.  From  the  fiftieth 
year  onward  it  is  better  to  fall  below  this  aver- 
age, while  very  old  people  might  dispense  with 
it  altogether.  During  the  period  of  pubescence 
the  allowance  should  be  rather  increased.  "Up 
to  the  tenth  or  twelfth  year  meat  should  be 
given  sparingly.  From  this  time  on  the  ration 
should  be  steadily  increased.  The  average  ra- 
tions which  I  am  disposed  to  grant  are  as  fol- 
lows: Meat,  well  trimmed,  boned,  and  cooked, 
100  to  120  grams  from  the  seventh  to  the  elev- 
enth year;  120  to  160  grams  from  the  eleventh 
to  the  sixteenth;  200  grams  and  over  from  the 
sixteenth  year  upward. ' ' l  More  abundant  al- 
lowance may  be  made  with  benefit  to  frail  and 
lymphatic  children,  and  to  such  as  are  predis- 
posed to  tuberculosis. 

1  Legendre  :  Cong-res  de  Paris,  1906. 


MEAT  35 

In  pathological  conditions  the  use  of  meat  is 
primarily  indicated  for  all  weak  persons,  conva- 
lescents, those  suffering  from  nervous  depression, 
and  all  who  have  to  repair  previous  losses  of  any 
kind. 

Tuberculosis  is  one  of  the  most  important  in- 
dications. Grancher  admits  that  in  England 
the  reduction  of  tuberculosis  coincided  with  the 
increase  of  meat  consumption.  All  authorities 
agree  as  to  the  necessity  of  heavy  rations  in 
nitrogenous  food  for  this  dire  disease. 

Gastric  stimulation,  uplift  of  tension,  increase 
in  humoral  acidity,  are  all  of  the  utmost  bene- 
fit in  cases  of  weak  tension  and  of  hypoacidity 
of  delicate  stomachs.  Richet  has  demonstrated 
that  raw  meat  possesses  merits  of  especial  effi- 
cacy, though  he  does  not  give  satisfactory  rea- 
sons why.  We  have  already  described  his 
method  of  preparation.  But  150  to  200  grams 
per  day  should  be  sufficient  for  all  purposes, 
and  according  to  A.  Robin  and  Binet  this 
amount  should  not  be  exceeded. 

Labbe  and  Vitry  have  pointed  out  the  dan- 
gers of  superalimentation  in  tuberculosis,  espe- 
cially in  its  advanced  stages,  as  intestinal  ab- 
sorption of  nitrogen  decreases  in  the  same  ratio 


36  WHAT  SHALL   I    EAT? 

as  ingestion  increases.  Mousseaux  calls  atten- 
tion to  cases  of  renal  lithiasis  due  to  the  same 
cause.  It  is  useful  to  know  these  facts,  for, 
while  they  prove  that  nitrogenous  superalimen- 
tation  in  tuberculosis  may  be  reasonable  and 
proper,  still  its  utility  is  by  no  means  as  yet 
established  beyond  a  doubt. 

Meat  is  also  an  appropriate  food  for  diabetics, 
on  account  of  its  small  content  of  carbohy- 
drates, but  we  say  this  with  caution,  as  it  may 
have  evil  effects  as  well.  Renal,  cardiovascular, 
and  cerebral  complications — the  latter  occur  fre- 
quently enough — are  pregnant  reasons  for  re- 
stricting, if  not  entirely  suppressing,  the  use  of 
meat.  Coma,  tendency  to  coma,  exaggerated 
acetonuria  constitute  absolute  contraindications; 
recourse  should  be  had  at  once  to  an  alkalizing 
and  antitoxic  regimen,  vegetarian  by  prefer- 
ence. 

Even  in  ordinary  cases  of  diabetes  without 
complications  a  nitrogenous  diet  should  be  care- 
fully considered,  as  some  patients  make  sugar 
with  albumin.  Linossier  and  Lemoine  have 
shown  that  it  is  necessary  to  distinguish  be- 
tween glycosuria  from  alimentation  (the  urine 
voided  fasting  does  not  show  traces  of  sugar),  in 


MEAT  37 

which  case  meat  is  excellent,  from  glycosuria  of 
nutrition  (the  maximum  of  sugar  is  in  the  urine 
of  the  fast),  when  the  albumin  must  be  reduced 
to  its  minimum. 

In  nearly  every  diet  advised  for  obesity,  meat 
plays  a  prominent  role,  because  it  possesses  the 
advantage  of  being  deprived  almost  entirely  of 
fatty  substances,  thus  increasing  the  activity  of 
the  organism;  but  it  must  not  be  eaten  with 
greasy  gravies.  Moreover,  particular  account 
must  be  taken  of  the  state  in  which  the  liver, 
heart,  and  blood-vessels  are  found. 

Its  use  in  gastrointestinal  affections  is  still 
very  much  under  discussion,  and  opinions  differ 
widely.  In  one  point,  however,  they  all  seem 
to  agree,  viz. :  that  the  meat  should  be  roasted 
or  boiled,  and  eaten  without  gravy  or  sauce,  cut 
into  small  morsels,  or  minced,  or  passed  through 
a  coarse  strainer. 

It  is  generally  advocated  in  hyposthenia  and 
in  dyspepsia  by  insufficiency,  in  all  of  which 
cases  it  serves  to  stimulate  the  secretions.  Like- 
wise in  gastric  putrefaction,  as  the  albumin  does 
not  ferment  in  the  stomach. 

In  hyperchlorhydria  Dujardin-Beaumetz  re- 
jects it  as  too -exciting,  A.  Robin  admits  it  as 

-    42G39 


38  WHAT  SHALL   I    EAT? 

useful  for  saturating  the  hydrochloric  acid.  We 
are  inclined  to  believe  with  him  that  it  should 
be  allowed  in  small  doses,  roasted  rather  than 
boiled.  In  certain  cases  aggravated  by  stubborn 
vomiting  and  emaciation,  a  broth  made  of  meat 
powder,  according  to  Debove's  method,  will 
give  very  good  results. 

In  cancer,  in  cases  of  inveterate  chronic  gastri- 
tis, meat  is  neither  tolerated  nor  is  it  desirable. 
Besides,  all  general  symptoms  should  be  care- 
fully watched  in  the  patient,  because  the  rules 
laid  down  for  these  instances  are  subject  to  nu- 
merous exceptions. 

Minced  or  raw  powdered  meat  is  very  service- 
able in  obstinate  chronic  diarrhea,  so  prevalent 
in  hot  countries.  Both  improve  the  general 
condition,  especially  that  of  the  bowels.  The 
same  beneficial  results  will  be  observed  in  per- 
sistent cases  of  enteritis  in  children  and  infants. 
Nobecourt  and  Rivet  have  arrived  at  very  inter- 
esting conclusions  regarding  this  subject,  viz. : 
if  salts  are  very  abundant  and  liquid  (aerobic 
flora),  raw  meat  is  indicated.  If,  on  the  con- 
trary, they  are  less  abundant  and  very  fetid, 
nitrogen  is  injurious  and  a  lacto-farinaceous 
regimen  is  required  (anaerobic  flora). 


MEAT  39 

A  meat  diet  is  also  useful  in  enteroptosis  in 
adolescents,  and  in  the  adult  with  weak  and  de- 
bilitated digestive  apparatus  who,  indeed,  stand 
in  need  of  gastric  rather  than  intestinal  alimen- 
tation. But  it  does  in  nowise  agree  with  entero- 
colitis,  constipation,  or  any  kind  of  disease  that 
inclines  to  cecal  stasis.  At  any  rate  only  the 
most  moderate  use  is  advisable  under  these 
circumstances,  and  then  only  if  the  meat  is 
unquestionably  fresh.  Game  and  delicatessen, 
which  precipitate  putrefaction,  must  be  totally 
avoided. 

There  are  cases  in  which  meat  is  unreservedly 
good  and  useful;  but  those  in  which  it  is  harm- 
ful and  absolutely  injurious  are  much  more  nu- 
merous. The  latter  comprise  chiefly  all  affec- 
tions of  the  heart  and  of  the  vascular  system,  of 
the  kidneys,  liver,  and  nervous  system,  and  last, 
but  not  least,  diathetic  arthritis. 

In  arterial  cardiopathy,  hypertension,  vascu- 
lar sclerosis,  aortitis,  and  angina  pectoris  it  is 
always  injurious.  Huchard  has  proved  its  ne- 
farious effects  in  the  genesis  of  a  whole  series  of 
symptoms,  beginning  with  toxic  alimentary  dys- 
pnea. The  physician  should  direct  all  efforts 
at  his  command  toward  the  most  rigid  exclusion 


40  WHAT  SHALL   I    EAT? 

of  all  meat  foods.  He  may  relent  somewhat  in 
cases  of  valvular  insufficiency;  the  animal  diet 
should  be  regulated  by  the  degree  of  compensa- 
tion observed. 

The  use  of  meat  in  diseases  of  the  kidneys  is 
a  rather  involved  problem.  In  all  acute  attacks 
of  uremia  it  must  be  absolutely  prohibited, 
while  in  orthostatic  albuminuria  it  will  do  more 
good  than  harm.  Between  their  two  extremes 
we  range  all  forms  of  chronic  nephritis — more  or 
less  compensated — for  which  absolute  rules  can- 
not be  given.  Although  muscular  meat  does 
not  agree  with  all  such  cases,  yet  it  cannot  be 
made  the  object  of  a  sweeping  prohibition.  The 
excellent  articles  by  Widal  on  dechlorated  diet, 
of  which  meat  forms  a  part,  have  contributed 
much  to  generalizing  its  employment.  A  care- 
ful watch  on  the  diuresis  and  albuminuria  of 
the  patient  will  be  a  great  help  in  testing  indi- 
vidual tolerance.  It  will  be  found  that  by  some 
it  is  borne  badly,  while  in  others,  especially  in 
younger  subjects,  it  has  a  tendency  to  diminish 
the  albuminuria  and  to  improve  the  general 
condition.  But  frequent  changes  in  the  diet  are 
always  beneficial.  The  more  acute  the  conges- 
tion of  the  kidneys,  the  stronger  the  misgivings 


MEAT  41 

as  to  the  effects  of  meat,  is  a  good  axiom.  In 
cases  of  inflammation  it  is  less  frequently  toler- 
ated than  in  fatty  degeneration. 

Wisdom  in  the  choice  of  meats  is  another 
commendable  factor  in  the  diet;  fowl  and  ham 
should  always  have  the  preference,  whilst  game, 
liver,  etc.,  should  be  kept  from  the  menu. 

In  liver  complaints  Robin  establishes  the  fol- 
lowing rules:  Meat  stimulates  the  cellular  func- 
tions, it  must  therefore  be  forbidden  in  all  cases 
in  which  these  are  already  exaggerated,  such 
as  hypertrophic  biliary  cirrhosis  in  the  initial 
stages,  atrophic  cirrhosis,  congested  enlargement 
of  the  liver  in  arthritis  and  all  malarial  affec- 

uu 

tions  and  colonial  diseases,  and  in  lithiasis,  in 
order  to  prevent  the  formation  of  calculi.  As  it 
wears  out  the  parenchyma,  it  can  only  do  harm 
in  acute  Jaundice,  acute  yellow  atrophy  of  the 
liver,  and  in  the  advanced  stages  of  atrophic  cir- 
rhosis. But  if  given  in  small  doses,  its  stimu- 
lating action  may  be  well  utilized  in  the  milder 
insufficiencies,  such  as  in  the  initial  stage  of 
the  second  period  of  Laennec's  cirrhosis,  and  in 
jaundice  as  soon  as  the  skin  begins  to  get  clear 
again. 

In  nervous  diseases  the  rules  are  not  so  severe, 


42  WHAT  SHALL   I    EAT? 

although  sensible  restriction  is  always  counseled, 
and  this  applies  with  similar  force  to  all  cases 
of  hypertension  and  neurasthenia,  and  all  affec- 
tions involving  lesions.  Some  authorities  are  be- 
ginning to  trace  the  origin  of  certain  diseases, 
the  etiology  of  which  is  vague  and  unknown, 
to  intestinal  troubles  of  very  old  standing. 
Londe  insists  that  the  source  of  the  symptoms, 
and  in  fact  the  whole  genesis  of  nervous  dis- 
eases, may  be  found  in  the  diet  of  the  patient, 
and  he  does  not  hesitate  to  consider  meat  as  one 
of  the  most  untrustworthy  factors  in  this  con- 
nection. 

We  have  reserved  the  consideration  of  arthri- 
tis to  the  very  last,  because  in  this  class  of  dis- 
eases an  animal  diet  plays  such  an  important 
role  and  is  so  difficult  to  control.  Arthritic  pa- 
tients are  apt  to  eat  too  much,  they  do  not  di- 
gest their  food,  are  troubled  in  consequence 
with  hyperacidity  and  autointoxication.  Meat 
tickles  the  palate  and  stimulates  the  appetite  to 
surfeit.  In  this  manner  oxidation  is  lessened, 
acidity  and  autointoxication  are  increased,  and 
nutrition  is  seriously  hampered.  If  arthritis  is 
due  to  overfeeding,  it  should  be  charged  princi- 
pally to  the  abuse  of  meat.  It  is  simply  sur- 


MEAT  43 

prising  to  see  morbid  symptoms,  such  as  neural- 
gia, articular  pains,  migraine  and  skin  diseases 
vanish  as  soon  as  the  patient  gives  up  meat  in 
every  shape  and  form,  after  therapeutic  agents 
have  failed  to  respond.  We  shall  refer  to  this 
again  later  on  in  the  chapter  on  vegetarianism. 
While  speaking  of  arthritis,  we  take  occasion 
to  particularly  mention  renal  lithiasis  and  uri- 
cemia  in  general,  skin  diseases  (eczema  particu- 
larly), and  hepatic  manifestations.  So  far  as 
gout  is  concerned,  the  authorities  are  of  differ- 
ent opinions.  Pascault  and  de  Grandmaison1 
are  in  favor  of  unrestricted  abstinence.  Garrod, 
Ebstein,  Cantani,  and  von  Noorden  advocate  a 
moderate  use.  Von  Noorden  claims  that  meat 
has  the  power  to  dissolve  uric  acid  by  its  content 
of  thymic  acid,  and  advises  to  test  the  suscep- 
tibility of  every  patient.  His  method  of  pro- 
cedure is  as  follows:  The  patient  is  to  be  put  on 
a  strictly  antipuric  diet.  The  uric  excretions 
are  to  be  carefully  examined  each  day.  The 
allowance  of  meat  must  not  exceed  100  grams. 
If  50  per  cent  of  the  purins  ingested  (the  rest 
is  always  oxidized)  are  found  in  the  urine,  the 
elimination  by  means  of  the  urine  is  normal,  and 
'De  Grandmaison:  Traite  de  1'arthritisme. 


44  WHAT  SHALL   I    EAT? 

the  allowance  of  meat  may  be  continued.  If 
otherwise,  it  must  be  discontinued.  The  same 
test  may  be  made  with  150  to  200  grams. 
Nevertheless,  we  are  inclined  to  the  belief  that 
gouty  subjects  might  do  well  with  a  smaller 
amount  of  nitrogen,  as  they  have  the  tendency 
to  make  uric  acid  even  with  albumin. 

PRESERVED    MEATS 

Those  preserved  in  tin  cans  lose  some  of  their 
nutritive  power  and  should  never  be  given  to 
patients  of  any  kind.  As  a  rule  they  are  put 
up  under  a  temperature  of  225°  to  230°,  and  are 
hermetically  sealed.  Generally  speaking  the 
muscular  portion  of  the  meat  retains  its  nutri- 
tive quality,  and  also  the  flavor  of  cooked  meat, 
while  the  high  temperature  destroys  the  mi- 
crobes and  toxic  elements,  always  supposing  that 
the  meat  employed  is  absolutely  fresh  and  un- 
tainted. But  the  utmost  care  should  be  exer- 
cised in  the  soldering  of  the  tins.  It  must  be 
done  on  the  outside  of  the  cans  and  never  come 
in  contact  with  the  jelly  that  forms  a  cover  to 
the  meat.  Unless  these  precautions  are  ob- 
served, ptomain-poisoning  is  sure  to  result. 

Salting  does  not  modify  the  composition  of 


MEAT  45 

muscular  meat  to  any  appreciable  extent. 
Pickling  slightly  disintegrates  the  albumin- 
oids, and,  perhaps,  the  extractive  substances  to 
a  higher  degree  even.  Meats  prepared  in  this 
fashion,  however,  are  certainly  less  toxic  and 
should  appeal  to  persons  who  are  afraid  of  auto- 
intoxication. Unfortunately  they  are  slightly 
hyperacid,  as  a  part  of  the  alkaline  phosphate 
of  potash  is  lost  in  the  pickle.  Still  this  is  in  a 
certain  measure  compensated  for  by  the  pres- 
ence of  salt,  although  it  is  a  feature  objection- 
able in  cases  of  nephritis.  Smoked  meats  are  a 
trifle  too  rich  in  albumin,  but  their  digestibility 
is  often  enhanced  by  the  process,  and  delicate 
stomachs  that  reject  cooked  meats  will  in  many 
cases  tolerate  them  very  well  indeed. 

Refrigerated  meat,  according  to  Gautier,  loses 
none  of  its  essential  qualities,  and  shows  but 
slight  modifications  of  its  original  composition. 


46  WHAT  SHALL   I    EAT? 

VEAL 

Albumin 18.00 

Fat 0.08— Chlorid.  .  .    0.06 

Carbohydrates.  .      0.00 

Ash 0.79 

Available  calories  =  155 

The  value  of  veal,  which  has  for  a  long  time, 
under  the  name  of  white  meat,  been  held  in 
high  repute,  though  quite  unjustifiably  so,  is  in 
many  ways  inferior  to  that  of  beef.  Being 
poorer  in  fat,  it  is  less  nutritive,  deficient  in 
myosin,  but  stronger  in  resisting  the  action  of 
the  acid  juices,  and  it  is  less  digestible,  as  has 
been  demonstrated  by  the  experiments  made 
by  Penzoldt.  Moreover,  as  is  the  case  with  all 
fresh  meats,  it  is  surcharged  with  nuclein  and 
xanthic  substances,  and  therefore  more  toxic. 
Many  persons,  although  not  dyspeptics,  cannot 
eat  veal  without  discomfort,  an  idiosyncrasy 
which  cannot  be  accounted  for. 

Cases  of  ptomain-poisoning  by  veal  are  of  fre- 
quent occurrence,  and  are  generally  accom- 
panied by  grave  symptoms,  such  as  severe  diar- 
rhea and  general  intestinal  intoxication.  Veal  is 
unfortunately  consumed  to  a  great  extent  in 


MEAT  47 

country  districts.  It  should  be  prohibited  in 
all  cases  of  dyspepsia,  eczema,  uremia,  nephritis, 
cystitis,  and  catarrh  of  the  urinary  tract. 

HORSE-MEAT 

As  the  consumption  of  horse-meat  is  con- 
stantly on  the  increase,  especially  in  large  cities, 
it  is  necessary  to  give  it  some  attention  here. 
Its  composition  stands  no  comparison  with  beef, 
on  account  of  the  small  amount  of  glycogen  it 
contains  (0.5  to  4.5  per  cent).  The  food  value 
is  the  same.  The  absence  of  cystin  in  the  mus- 
cles recommends  it  rather  as  suitable  for  raw- 
meat  cures.  It  is  wise,  however,  to  take  here 
into  consideration  that  a  great  many  worn  out, 
emaciated,  and  exhausted  horses  find  their  way 
into  the  slaughter-houses,  and  that  for  this  rea- 
son alone  horse-meat  in  general  not  only  pos- 
sesses a  lesser  grade  of  value  as  a  food,  but  is  in 
many  instances  absolutely  injurious  to  the  con- 
sumer. 


48  WHAT  SHALL   I    EAT? 

MUTTON 

Albumin 15.30 

Fat 16.001— Chlorid.  .  .    0.06 

Carbohydrates.  .      0.00  — Purin 0.11 

Ash 1.00 

Available  calories  =170 

Mutton  is  not  quite  as  rich  in  albumin  as 
beef,  but  it  contains  more  fat  and  mineral  sub- 
stances. Its  nutritive  power  is,  therefore,  lower, 
but  it  is  not  as  readily  digested.  Uncooked  it 
has  great  renown  as  a  cure  for  consumption. 

Lamb  may  practically  be  accepted  as  the 
equal  of  mutton,  though  it  is  rather  insipid  in 
taste. 

PORK 

Albumin 16.20 

Fat 32. 101— Chlorid  .  .    0.06 

Carbohydrates.  .      0.00  — Purin 0.10 

Ash 0.50 

Available  calories  =  370 

Excess  of  fat  and  close  fiber  of  the  meat  are 
the  characteristics  of  pork,  which  make  it  less 
digestible.  Many  stomachs  cannot  bear  it. 

'This  includes  the  fat  underlying  the  skin,  which  is  always 
present  in  abundant  quantities. 


MEAT  49 

But  its  nutritive  value  is  higher,  while  the  price 
is  lower  than  that  of  beef.  Thus  it  is  one  of 
our  staple  foods. 

Pork  is  at  times  tainted  with  trichinae  (trichi- 
nosis), parasites  which  live  in  the  muscular  tis- 
sue and  affect  man  seriously  when  introduced 
into  his  system.  On  the  Continent  of  Europe 
this  danger  is  greatly  forestalled  by  a  rigorous, 
governmental  inspection  of  the  slaughter-houses. 

Ham  deserves  special  mention  here.  Because 
the  meat  of  the  ham  is  finer  and  shorter  in  fiber, 
it  is  easier  to  digest,  and  forms  a  valuable  food 
in  cases  of  gastric  or  intestinal  dyspepsia.  In 
nephritis  it  may  be  recommended  for  the  reasons 
that  it  is  easily  assimilated  and  puts  no  strain 
on  the  kidneys;  likewise  in  cases  of  albuminuria 
or  hepatic  congestion,  as  it  allows  but  the  mini- 
mum amount  of  albumin  to  pass  through  the 

kidneys. 

#         #         # 

We  now  come  to  a  category  of  foodstuffs  which 
hardly  contain  any  muscular  fiber,  and,  there- 
fore, do  not  deserve,  properly  speaking,  the 
name  of  meat-food.  But  since  they  are  of  ani- 
mal origin,  this  certainly  is  the  place  for  men- 
tioning their  qualities  and  properties. 


50  WHAT  SHALL   I    EAT? 

We  mean  the  entrails  (tripe,  etc. ),  glands, 
heart,  and  the  tissues  and  organs  less  differ- 
entiated, such  as  the  skin,  bones,  and  tendons 
which  we  shall  divide,  according  to  the  nutritive 
qualities  so  intimately  connected  with  their  his- 
tological  structure,  into  three  classes,  viz. :  gela- 
tinous substances,  glands,  and  those  organs 
which  are  rich  in  nuclein. 

GELATINOUS   SUBSTANCES 

These  comprise  the  head  and  feet  of  the  swine, 
calf,  lamb,  and  mutton.  They  contain  some 
muscular  tissue,  assimilable  albuminoids,  and  a 
small  percentage  of  fat.  The  chief  constituents, 
however,  are  elastic  and  connective  tissues,  the 
periosteum  and  cartilage,  which,  when  boiled, 
are  transformed  into  gelatin,  rich  in  nuclein. 
To  obtain  good  results  and  proper  assimila- 
tion, prolonged  cooking  is  required. 

Gelatin  is  a  most  useful  agent  for  the  human 
economy,  and,  we  think,  ordinarily  too  much 
neglected. 

Gelatin  possesses  very  valuable  properties. 
Being  totally  absorbed  by  the  intestines,  it  exer- 
cises a  marked  influence  on  the  economy  of 
metabolism.  Its  action  is  primarily  directed 


MEAT  51 

toward  the  albumins,  but  affects  also  in  a  lesser 
degree  the  fats.  In  the  first  instance  it  exceeds 
that  of  the  carbohydrates  by  two. 

Numerous  experiments  have  demonstrated 
that  the  addition  of  gelatin  to  food  notably 
reduces  the  ratio  of  nitrogenous  repair. 

Gelatinous  foods  are  particularly  recom- 
mended to  those  who  get  easily  overheated,  or 
who  must  build  up  their  system:  emaciated, 
convalescent,  or  jaded  persons.  A.  Robin  claims 
that  they  are  of  great  service  to  consump- 
tives, in  whom  disassimilation  always  takes  place 
in  an  exaggerated  measure.  On  the  other  hand, 
they  are  pernicious  in  cases  of  gout,  uremia,  and 
arthritis;  and,  on  account  of  the  excess  of  nu- 
clein  contained  in  them,  also  in  nephritis  and 
dyspepsia.  But  there  is  no  reason  why  these 
patients  should  not  partake  of  such  jellies  that 
are  nutrient  as  well  as  agreeable  to  the  digestive 
organs.  Senator  recommends  for  treatment  of 
ulcers  a  diet  composed  of  gelatin,  sugar,  and 
fat1 


formula  is  as  follows  :  Dissolve  15  to  20  grams  of  gela- 
tin in  200  grams  of  water,  add  50  grams  oleosaccharin  of  lemon. 
To  be  taken  within  twenty-four  hours  together  with  J  of  a  liter 
(|  pint)  of  cream  and  30  grams  of  butter.  The  total  =900  to 
1,000  calories.  —  (Berlin  Medical  Society,  January  8,  1906.) 


52  WHAT  SHALL   I    EAT? 

ORGANS   RICH   IN   NUCLEIN 

LIVER,   KIDNEYS,    SWEETBREAD    (THYMUS  GLAND ) 

All  these  organs,  which  come  from  cattle, 
calves,  or  pigs,  are  rich  in  nuclein.  Sweetbread 
easily  takes  the  first  place  in  accordance  with 
the  histological  formula  of  its  composition. 
Liver  contains  only  one-fourth  the  amount  of 
nuclein  found  in  sweetbread,  and  kidneys  even 
less  than  that.  On  general  principles  none  of 
them  is  fit  for  use  in  cases  of  uremia,  gout,  stone, 
or  arthritis. 

LIVER 

Albumin 19-9 

Fat 3.6— Chlorid.  .  .    0.08 

Carbohydrates.  .  .      0.5— Purin 0.33 

Ash 1.6 

Available  calories  =  145 

Gelatinous  substances  are  present  in  abun- 
dance. Glycogen  varies  from  1  to  16  per  cent. 
Lecithin  and  phosphorous  fats  are  plentiful  (see 
Eggs,  page  152)  in  goose  liver,  even  up  to  30 
per  cent.  These,  combined  with  nuclein,  make 
liver  a  food  rich  in  organic  phosphorus.  As  it  is 
readily  and  quickly  digested,  it  may  be  strongly 


MEAT  53 

recommended  to  convalescents,  in  the  period  of 
adolescent  growth,  to  phthisical  individuals,  and 
in  cases  of  slight  neurasthenia. 

Liver  is  frequently  employed  as  an  organo- 
therapeutic  medium  in  icterus,  atrophic  cirrhosis, 
and  hepatic  sluggishness.  It  should  be  taken 
raw,  or  but  slightly  cooked.  A  temperature 
exceeding  140°  Fahrenheit  coagulates  the  albu- 
min and  destroys  its  useful  ferments. 

Pig's  liver  is  preferable,  but  it  must  be  quite 
fresh.  The  dose  is  100  to  200  grams.  It  may 
be  administered  raw  as  an  enema  after  it  has 
been  crushed  and  emulsified  with  the  serum,  or 
by  the  mouth  after  being  slightly  cooked,  in 
order  to  remove  its  disagreeable,  insipid  taste. 

KIDNEY 

Albumin 18.4 

Fat 4.5 

Carbohydrates...      0.0— Chlorid.  .  .    0.26 

Ash 1.2 

Available  calories  =  124 

The  absence  of  glycogen,  and  the  negligible 
quantity  of  lecithin  it  contains,  diminish  the 
nutritive  value  of  kidney.  Nevertheless  it  is  a 
food  easy  to  digest;  but,  to  be  good,  it  must  be 


54  WHAT  SHALL  I   EAT? 

taken  from  young,  herbivorous  animals.  The 
kidneys  of  old  and  carnivorous  animals  should 
be  eschewed.  —  (Gautier. ) 

The  renal  glands  have  also  been  employed  in 
organotherapy  in  albuminuria  and  sluggishness 
of  the  kidneys.  The  results  obtained  are,  it  is 
true,  of  a  contradictory  nature;  but  cases  are  on 
record  in  which  marked  improvement  has  been 
observed.  It  may  be  administered  like  the 
liver,  either  by  the  mouth,  raw  or  slightly 
cooked,  or  as  an  enema  emulsified  with  the 
serum. 

SWEETBREAD 

Albumin 22.0 

Fat 0.4 

Carbohydrates...      0.0 — Purin 1.20 

Ash 1.6 

Available  calories  =  1 23 

Besides  its  exceptional  abundance  of  nuclein, 
which  alone  gives  it  a  predominant  place  among 
phosphoric  nutrients,  it  abounds  in  collagenous 
substances.  It  is  easy  to  digest  and  may  well 
be  recommended — even  more  so  than  liver — to 
convalescents,  and  to  debilitated  and  nervous 
persons. 


MEAT  55 

BRAIN 

Albumin 12.78 

Fat 15.59 

Carbohydrates 0.00 

Ash 0.89 

Available  calories  —  202 

Although  it  is  poor  in  nuclein,  it  contains  a 
surplus  of  lecithin  approaching  that  of  the  yolk 
of  the  egg.  At  all  times  brain  has  been  consid- 
ered a  typical  phosphoric  nutriment.  In  this 
regard  it  is  only  second  to  the  yolk  of  the  egg 
and  to  sweetbread  in  the  animal  kingdom,  and 
to  spinach,  cabbage,  the  legumes,  and  barley  in 
the  vegetable  kingdom.  It  is  nevertheless  a 
food  for  rephosphatization.  It  is  easy  of  diges- 
tion, if  one  is  careful  in  removing  the  mem- 
branes. It  agrees  marvelously  well  with  conval- 
escents who  have  a  weak  stomach,  and  benefits 
those  who  surfer  from  depletion  of  phosphorus. 


56  WHAT  SHALL   I    EAT? 

MARROW 

Albumin 1.87 

Fat 88.04 

Carbohydrates 0.00 

Ash 1.53 

Available  calories  =  862 

Mark  the  heavy  proportion  of  ash  and  of  fats 
which,  moreover,  are  phosphoric  fats.  Marrow 
is,  indeed,  a  nutrient,  phosphoric,  mineralized 
food  element.  The  figures  which  we  have  given 
soar  up  to  those  given  for  beef  in  the  adult  ani- 
mal. In  young  animals  fat  is  not  yet  abundant, 
but  nuclein  is  fast  accumulating,  whilst  the 
marrow  is  still  active  in  the  process  of  blood- 
making. 

That  is  the  reason  why  the  marrow  of  young 
animals  is  employed  in  organotherapy  for  cer- 
tain cases  of  anemia  due  to  inability  of  making 
blood-corpuscles.  Very  encouraging  results  have 
been  obtained  in  aplastic  anemia.  The  method 
of  administration  is  the  same  as  indicated  for 
liver  and  kidney. 


MEAT  57 

DELICATESSEN 

Under  this  name  we  comprise  a  considerable 
number  of  foods,  in  the  preparation  of  which 
nearly  all  parts  of  the  animal,  predominantly 
those  of  the  pig,  are  utilized.  Every  country 
has  its  own  individual  style  and  recipes,  and  its 
own  particular  names  and  labels.  We  must, 
therefore,  here  confine  ourselves  on  general 
principles  to  a  few  words  as  regards  these  prod- 
ucts of  universal  consumption. 

A  mixture  or  medley  of  cooked  or  raw  meat 
materials,  the  offal  which  cannot  be  used  in  its 
natural  state,  such  as  the  heart,  the  lungs,  the 
spleen,  the  blood,  fats,  with  spices  varying  in 
number  and  quantity,  all  are  used  in  this  enter- 
prise, and  they  possess  a  fairly  high  food  value. 

Perhaps  they  are  also  enriched  by  the  addi- 
tion of  vegetable  substances  as,  for  instance,  the 
famous  pea  sausage  of  the  German  army.  But 
that  is,  perhaps,  the  only  good  quality  they 
possess,  for  from  the  hygienic  standpoint  they 
present  many  defects. 

1.  They  are  a  food  hard  to  digest,  placing  a 
heavy  embargo  on  the  stomach  as  well  as  on  the 
bowels.  The  materials  used  for  making  them 


58  WHAT  SHALL   I    EAT? 

are  heavy,  especially  so  if  they  cannot  be  cooked. 
Besides,  foreign  products  may  be  introduced 
unbeknown  to  the  consumer. 

2.  They  are  apt  to  produce  intestinal  putre- 
faction.    Waste  material   and   decayed  matter 
may  slip  in   unperceived   in  the  manufacture. 
Even  if  well  made,  they  yet  offer  an  excellent 
culture  medium  for  intestinal  microbes. 

3.  They  constitute  also  an  ever-present  dan- 
ger of  infection  to  the  whole  system. 

4.  Moreover,  they  are  a  food  relatively  expen- 
sive.    One  gram  of  nitrogen  contained  in  this 
foodstuff  costs  more  than  that  contained  in  fresh 
meat. 

With  rare  exceptions  they  offer  but  a  mediocre 
means  of  sustenance  to  the  person  in  good  health, 
and  it  is  always  wise  to  distrust  them,  for  they 
certainly  are  crude  materials.  It  is  a  matter  of 
regret  that  these  preparations  have  obtained  such 
a  prominent  place  on  the  tables  of  the  poor. 

It  is  needless  to  say  that  they  are  forbidden 
the  sick,  all  who  have  delicate  stomachs,  who 
are  afflicted  with  intestinal  fermentations  and 
intoxications,  or  who  suffer  from  heart  trouble  or 
Bright* s  disease,  eczema,  gout,  liver  complaint, 
or  arthritis. 


MEAT  59 

SOME   PARTICULARS 

Sausage  is  made  of  meat  offals  and  the  fat 
of  either  beef  or  pig,  highly  seasoned,  finely 
chopped,  and  pressed  into  cleaned  entrails  of 
some  animal.  The  food  value  of  sausage  de- 
pends upon  the  characteristics  of  its  constituents. 
The  following  table,  compiled  by  d'Alquier, 
shows  the  composition  of  three  of  the  best 
known  varieties: 

Carbo- 
Albumin.         Fats.        hydrates.      Ash.        Calories. 

Cervelat 23.21  43.62  0  4.48  512 

Ham  Sausage 37.06  34.10  0  3.66  483 

Sausages,    small,    for 

frying 16.62  37.71  0  2.85  427 

The  small  sausages  which  are  sold  in  links, 
chiefly  for  the  breakfast  -  table,  are  rich  in 
grease,  and  must  be  well  cooked  or  fried. 

Head  Cheese  is  a  mixture  of  different  kinds 
of  meat,  gelatin,  and  bouillon,  and  contains: 
albumin,  19.89;  fat,  32.16;  carbohydrates,  0; 
ash,  2.36;  calories,  389. 

Galantin  is  a  mixture  of  pork,  ham,  and  fowl, 
contains  less  fat,  and,  therefore,  less  nourish- 
ment, but  is  easier  to  digest  and  more  harm- 
less. Albumin,  41.30;  fat,  6.10;  carbohydrates, 
0;  ash,  1.88;  calories,  239. 


60  WHAT  SHALL   I    EAT? 

Meat-pie  is  harder  to  digest,  on  account  of  the 
paste  and  crust  (see  Pastry,  p.  201). 

It  is  made  of  all  kinds  of  meat — veal,  pork, 
duck,  game,  etc.,  which  naturally  impart  to  it 
all  their  own  good  or  bad  qualities;  but  hot  it 
is  always  heavier  than  cold. 

Pate  de  fois  gras  shows  albumin,  16.30;  fat, 
38.34;  carbohydrates,  0;  ash,  1.67;  calories, 
432. 

It  is  a  very  nourishing  food,  rich  in  lecithin, 
and  often  enough  easily  tolerated  even  by  deli- 
cate stomachs.  This  is  particularly  the  case  if 
the  liver  is  taken  from  geese  or  ducks  especially 
fattened  for  the  purpose.  As  it  is  highly  sea- 
soned and  contains  truffles,  those  who  suffer 
from  Bright' s  disease,  arthritis,  or  eczema,  must 
eschew  it.  For  making  adipose  tissue  it  is  of 
great  value,  likewise  to  consumptives. 

Black  pudding,  or  blood  pudding,  made  of  the 
blood  of  pigs  and  lard  and  spices,  is  heavy  and 
indigestible.  It  is  generally  eaten  with  mus- 
tard. Blood  is  a  good  culture  medium  for  mi- 
crobes, for  which  reason  the  pudding  should 
always  be  absolutely  fresh  and  thoroughly 
cooked.  It  is  not  a  dish  to  be  recommended, 
despite  the  fact  that  it  is  rich  in  iron. 


Albumin. 

Chicken...    18.87 
Pigeon  21.97 
Duck              22.58 

Fat.      1 

12.89 
3.71 

4.94 

lydrates 

0 
0 

o 

Ash. 

0.77 
0.85 
0.91 

Chloridi 

0.06 
0.06 
0.06 

Turkey  .  .  .    20.95 
Goose  15.21 
We  add  here 
Rabbit.  .    22.59 

21.76 
31.86 

4.06 

0 
0 

0 

0.75 
0.41 

0.85 

0.06 
0.06 

0.06 

MEAT  61 

POULTRY 

BARNYARD   MEATS 

COMPOSITION    AND    FOOD-VALUE 

Car  bo- 
Ash.       Chlorids. 

0.15  204 
131 
145 

0.15  299 
366 

0.11   137 

Generally  speaking,  the  percentage  of  nitro- 
gen is  higher  than  in  beef.  Uric  acid  is  also 
more  abundant,  as  is  the  case  in  all  birds.  The 
nutritive  power  depends  on  the  proportion  of 
fat  which  abounds  in  goose  and  turkey,  but  is 
scarce  in  pigeon,  duck,  and  rabbit. 

USE   AND    METHODS   OF    PREPARATION 

Fowl  is  principally  served  roasted,  and  all 
that  we  have  said  about  butcher's  meat  is  here 
applicable.  When  fried,  fowl  is  serviceable  to 
dyspeptics,  as  the  congealed  fat  is  easy  to  elimi- 
nate, while  it  appeals  also,  perhaps,  more  to  the 
taste  and  is  less  stimulating. 

Fowl  should  be  bled  and  not  choked. 


62  WHAT  SHALL   I    EAT? 

REACTIONS — INDICATIONS 

For  a  long  time  a  distinction  was  made  be- 
tween white  and  red  meat,  attributing  to  each 
quite  different  qualities,  strongly  in  favor  of  the 
white  meat.  It  was  claimed  that  the  red  meat 
produced  excitement,  congestion,  and  toxins, 
while  the  white  meat  was  easier  to  digest,  less 
irritating,  and  devoid  of  troublesome  after- 
effects. Opposite  effects  in  the  temper,  mood, 
and  character  of  man  were  attributed  to  the  red 
meat.  So  it  was  said  that  when  Garrick,  the 
famous  English  actor,  had  to  appear  in  the  role 
of  a  hero,  he  fed  on  roast  beef;  but  on  mutton 
when  he  had  to  play  the  simpleton.  Science 
does  not  admit  such  ridiculous  claims  nowadays. 
In  fact  a  complete  reaction  has  taken  place  in 
this  regard,  and  the  tendency  now  is  to  give 
preference  to  the  red  over  the  white  meats. 

This  new  doctrine  is  quite  absolute.  The 
color  of  the  meat  is  a  matter  of  secondary  con- 
sideration only,  and  can  in  nowise  prejudice  its 
physical  or  chemical  properties.  It  cannot  serve 
as  the  basis  for  a  correct  physiological  classifica- 
tion. We  will,  however,  make  certain  general 
observations  on  the  comparative  value  of  red  and 


MEAT  63 

white  meat   as  foodstuffs,   and   separately  con- 
sider the  digestive  and  general  reaction  of  each. 

1st.  So  far  as  digestion  is  concerned  it  will  be 
generally  admitted  that  chicken  and  pigeon  are 
better  tolerated  by  weak  stomachs  than  butcher's 
meat,  because  they  contain  less  fat.  This  must 
be  emphasized  with  regard  to  chicken  in  which 
the  grain  of  the  fiber  or  its  membrane  is  ever 
so  much  finer.  A  convalescent  or  a  neurasthenic 
with  an  enfeebled  stomach  can  eat  with  more 
comfort  and  less  risk  the  wing  of  a  chicken  than 
a  piece  of  beefsteak. 

On  the  contrary,  duck,  turkey,  and  goose  are 
harder  to  digest  than  red  meat,  and  should  be 
rigidly  excluded  from  the  table  of  the  dyspeptic 
and  the  typhoid-fever  patient.  We  have  already 
spoken  of  veal  and  pork.  So  it  would  be  useless 
to  revert  to  them  here  again. 

2d.  From  a  general  point  of  view  everything 
speaks  in  favor  of  red  meat.  It  is  more  nourish- 
ing, contains  more  iron,  and  is  an  important 
article  of  food  for  the  adult.  It  contains  a  sen- 
sibly smaller  amount  of  extractive  matter,  and, 
in  consequence,  is  less  irritant  and  toxic. 

In  summing  up  we  repeat  that,  if  chicken  and 
pigeon  are  of  service  to  the  feeble  and  dyspeptic, 


64  WHAT  SHALL   I    EAT? 

the  red  meats  are  better  for  him  who  is  recover- 
ing from  an  attack  of  arthritis. 

GAME 

COMPOSITION   AND   FOOD   VALUE 

Car  bo- 
Albumin.         Fat.        hydrates.     Ash.  Calories. 

Quail 22.80  7.60  0  1.20  171.60 

Thrush 22.87  1.68  0  1.14  116.42 

Partridge 24.46  1.36  0  1.04  120-42 

Venison 20.55  1.82  0  0.85  107.53 

The  meat  of  game  possesses  three  principal 
qualities:  1.  A  high  percentage  of  albumin;  2, 
a  small  amount  of  fat;  and  3,  a  strong  propor- 
tion of  extractive  bodies,  particularly  creatin. 
These  are  present  in  a  higher  degree  in  animals 
that  are  killed  in  the  hunt,  which  should  be 
prohibited  by  law.  The  violent  muscular  over- 
exertion,  which  precedes  death,  gathers  in  the 
muscular  tissues,  in  fact  in  the  whole  organism, 
a  mass  of  xanthic  toxins  which  there  is  no  time 
to  eliminate. 

Game  undergoes  frequently  complicated  culi- 
nary preparations,  which  unfortunately  increase 
all  its  objectionable  features.  Jugged  hare, 
partridge  in  cabbage,  and  others  are  risky  dishes, 
because  the  toxins  of  the  blood  become  mingled 


MEAT  65 

with  those  of  the  muscular  tissues.  The  same 
may  be  said  about  the  salines  (ragouts)  of  wood- 
cock, in  which  case  the  entrails  that  are  left  in 
the  bird  invite  infection  and  intoxication. 

The  habit  of  hanging  game  until  it  "gets 
high"  is  objectionable  and  antihygienic.  The 
meat  of  game,  like  that  of  all  wild  animals, 
is  rather  harsh  and  tough.  The  cadaveric  rigid- 
ity of  the  dead  beast  serves  to  increase  these 
qualities.  Moreover,  the  meat  is  generally  sev- 
eral days  old  before  it  reaches  the  kitchen. 
Hunters  are,  as  a  rule,  endowed  with  a  veritable 
perversion  of  taste,  and  imagine  that  game 
appeals  to  the  palate  only  when  it  is  "  high, ' ' 
i.e.,  wrhen  it  smells  strong  and  when  putrefac- 
tion is  already  well  advanced.  The  process  of 
decay  is  not  only  accomplished  by  the  formation 
of  toxins,  but  is  a  genuine  hotbed  for  micro- 
organisms, whence  frequently  spring  gastric 
troubles  and  enteric  disorders.  We  had  a  case  of 
a  strong,  healthy  man  who  contracted  typhoid 
fever  of  the  gravest  nature  from  eating  a  part- 
ridge that  was  too  far  advanced.  We  cannot 
too  strongly  condemn  such  habits,  which  are 
bound  to  endanger  the  health  of  even  the  most 
robust. 


66  WHAT  SHALL  I   EAT? 

Venison  may  be  prepared  in  a  perfectly  safe 
and  sound  way  by  pickling  in  the  following 
manner: 

Place  the  best  cut  into  a  basin  or  large  pot, 
add  salt,  pepper,  bay-leaves,  spices,  etc.,  accord- 
ing to  taste;  pour  vinegar  over  the  meat,  adding 
a  few  drops  of  olive-oil.  Turn  the  meat  over 
once  or  twice  every  twenty-four  hours.  This 
method  will  prevent  the  meat  from  spoiling, 
but  will  make  it  tender  and  give  it  a  most 
agreeable  flavor. 

REACTIONS — INDICATIONS 

Game  is  hard  to  digest,  and  favors  a  rapid 
development  of  micro-organisms  in  the  intes- 
tines. It  should  be  banished  from  the  menu  of 
dyspeptics,  and  those  who  suffer  from  enteric 
or  enterocolic  affections.  Small  birds,  such  as 
quail,  thrush,  partridge,  lark,  may  here  be  ex- 
cepted,  on  the  condition,  however,  that  they  are 
absolutely  fresh  when  eaten  and  have  not  been 
"hung." 

Game,  on  account  of  the  toxic  substances  it 
contains,  is  ever  dangerous  to  the  circulatory 
system;  it  contracts  the  small  vessels  and  in- 
creases the  action  of  the  heart.  For  this  reason 


MEAT  67 

it  is  bad  in  cases  of  cardiac  affections  and 
hypertension.  In  Bright' s  disease  its  use  should 
be  prohibited,  as  it  affects  the  renal  capsules. 
It  excites  the  nervous  system,  for  which  reason 
it  is  not  suitable  for  neurasthenics.  And  for  all 
these  reasons  it  is  not  a  fit  dish  in  arthritis, 
eczema,  or  liver  complaints.  Consumptives,  who 
are  so  much  interested  in  watching  their  diet 
carefully,  should  make  only  small  use  of  it. 


68  WHAT  SHALL   I    EAT? 

EXTRACTS  MADE  FROM  MEAT 

BOUILLON,  SOUP,  BEEF-TEA 

Albumin 1.21 

Fat 0.32— Chlorid 1 

Carbohydrates.  ...  0.44 

Ash 0.31 

COMPOSITION   AND    FOOD   VALUE 

Soup  contains  a  few  of  the  divers  constituents 
of  meat,  but  in  variable  proportions.  Fat  is 
present  only  in  small  quantities,  as  it  is  gener- 
ally skimmed  off  in  the  cooking.  For  delicate 
stomachs  this  is  all  right,  but  it  takes  a  great 
deal  of  the  nutritive  quality  away  from  the 
soup.  Albuminoids  are  more  abundant,  unless 
they  are  largely  removed  in  the  skimming. 
The  remainder  is  principally  composed  of  albu- 
min, which  in  the  boiling  is  partially  trans- 
formed into  albumose  and  peptones;  and  also  of 
gelatin  derived  from  the  meat  fiber  and  from 
the  bones.  Xanthic  matter  is  plentiful.  Crea- 
tin,  xanthin,  hypoxanthin  pass  into  the  soup 
and  constitute  a  large  portion  of  its  physiologi- 
cal properties.  Salt  evaporates  almost  com- 
pletely. About  four-fifths  of  the  essential  salts 


MEAT  69 

in  meat  are  lost,  and  have  to  be  replaced  by 
the  addition  of  ordinary  table  salt.  Unless 
salt  is  added  artificially,  phosphates,  chiefly 
phosphate  of  lime,  will  predominate.  The  ash 
is  acid. 

Thus  it  will  be  seen  that  soup  contains  but 
a  minimum  of  nutritive  power.  Pure  water 
should  only  be  added  in  the  proportion  of  1  liter 
to  40  grams  of  meat,  which  will  preserve  an 
abundant  proportion  of  the  mineral  constituents. 

How  to  Make  Soup.  — This  is  simple  and  easy 
enough.  The  best  proportions,  according  to 
Chevreul,  are:  2  pounds  of  lean  beef,  2^  liters 
(5  pints)  of  water,  18  grams  of  table  salt,  and 
110  grams  of  vegetables  (carrots,  turnips,  leek, 
celery,  etc. ). 

But  if  you  want  to  make  a  really  good  soup, 
then  plunge  the  meat  into  cold  water  and  at 
once  bring  to  a  boil.  This  insures  a  more  thor- 
ough dissolution  of  the  meat  substances.  Of 
course,  the  soup  must  be  skimmed  before 
serving. 

If  the  meat  is  put  into  water  that  is  already 
boiling,  the  albumin  is  apt  to  coagulate  on  the 
surface  and,  by  forming  a  crust  or  scum,  to  im- 
pede the  proper  issue  of  the  alimentary  compo- 


70  WHAT  SHALL  I   EAT? 

nents;  the  meat  may  taste  better  and  more 
savory,  but  the  soup  loses  much  of  its  value. 

What  is  known  as  "bottle  soup"  is,  however, 
the  most  nutritive  of  all,  especially  if  it  be  taken 
only  by  the  spoonful.  The  method  of  prepar- 
ing it  is  as  follows:  Cut  the  meat,  after  remov- 
ing the  fat,  into  square  pieces  about  three- 
eighths  of  an  inch  in  thickness,  and  put  them 
into  a  large-mouthed  bottle  which  can  be  firmly 
closed.  Without  any  additions,  the  bottle  is 
placed  in  a  steamer  and  allowed  to  boil  for 
twenty  minutes.  Three  hundred  grams  of  meat 
will  give  about  100  cubic  centimeters  of  a  deep 
brown  liquid,  of  good  strong  flavor  and  taste, 
which  can  be  used  ad  libitum. 

Soup  made  from  the  knuckle  of  veal  has  the 
advantage  of  being  more  gelatinous.  Chicken 
soup  is  easy  to  digest,  and  also  rich  in  gelatin. 

Reactions.  — The  action  of  soup  on  the  stomach 
is  very  marked.  It  strongly  stimulates  secre- 
tion. Pauloff  has  definitely  proved  that  this 
stimulation  is  due  to  the  extractive  substances 
contained  in  soup  to  a  very  large  extent.  When 
the  psychical  fluid  fails,  soup  steps  in  by  start- 
ing the  flow  of  the  gastric  juices  which  then 
continue  to  flow  by  its  own  force.  Its  use  at 


MEAT  71 

the  beginning  of  the  repast  is,  therefore,  fully 
justified,  especially  in  cases  of  anorexia. 

The  intestinal  reaction  is,  however,  quite  in- 
significant. Soup  is  a  typical  gastric  food. 
Consisting  of  peptones,  xanthic  matter,  and 
salts,  it  is  wholly  absorbed  by  the  system  with- 
out further  efforts  on  the  part  of  the  digestive 
organs. 

The  heart,  the  blood-vessels,  the  nervous  sys- 
tem are  all  strongly  affected  and  stimulated 
by  it.  Soup  is  really  a  nerve  food,  almost 
akin  to  alcohol  and  coffee.  "The  physiological 
effects  produced  by  the  creatin  and  xanthic 
leucomains,  components  both  tonic  and  bitter, 
which  are  largely  ingested  in  small  doses  and 
not  injected  under  the  skin,  may  well  be  com- 
pared to  those  of  caffein  and  thein,  which  we 
derive  from  tea,  coffee,  and  cocoa."  —(Gautier.) 

The  action  of  soup  on  the  renal  functions  is 
more  difficult  to  calculate,  because  here  certain 
elements  have  opposite  effects.  This  much 
may,  however,  be  claimed  that,  if  taken  in  small 
doses  and,  granted,  that  the  renal  epithelium  is 
intact,  soup  exercises  a  benign  influence  on  the 
process  of  elimination,  whether  this  be  indirect 
by  relieving  the  tension  of  or  by  giving  tone  to 


72  WHAT  SHALL   I    EAT? 

the  heart's  action,  or  direct  by  means  of  the 
salts  of  potash  present  in  it.  This  is  the  opinion 
of  Gautier,  who  contends  that  soup  accelerates 
the  action  of  the  kidneys.  But  the  same  dose 
that  stimulates  the  epithelium  when  intact,  may 
have  the  very  opposite  effect  on  the  diseased  tis- 
sue. It  is  certain  that  if  the  kidneys  are  disor- 
dered, soup  carries  into  them  those  objectionable 
toxins  quoted  by  its  adversaries,  the  more  so  as 
it  adds  a  large  amount  of  salt  to  the  injurious 
effects  of  the  leucomains. 

Indications  and  Contraindications.  — Inasmuch 
as  soup  is,  practically  speaking,  an  extract  of 
meat,  it  shares  with  the  latter  all  its  advantages 
and  disadvantages,  and  we  do  not  repeat  our- 
selves when  we  here  take  occasion  to  emphasize 
its  features. 

It  is  an  excellent  food  for  the  feeble,  for  con- 
valescents, dyspeptics,  atonies,  and  those  with  low 
tension.  It  is  a  food  for  remineralization,  highly 
to  be  recommended  to  all  who  suffer  from  loss 
of  the  important  mineral  ingredients.  On  this 
head  and  as  an  aid  to  digestion,  consumptives  are 
well  advised  in  making  a  moderate  use  of  it. 

The  more  important  contraindications  are 
kidney  troubles,  whether  acute  or  chronic,  on  the 


MEAT  73 

one  hand,  and  cardiovascular  affections  of  any 
kind,  on  the  other.  It  is  to  be  shunned  by  all 
who  suffer  from  hypertension,  angina,  or  from 
atheromatous  or  aortic  affections.  We  have  in 
view  a  case  of  a  patient  in  full  convalescence 
from  an  attack  of  asystole,  who  brought  about  a 
relapse  of  the  gravest  nature  by  eating  a  plate 
of  soup  surreptitiously. 

In  cases  of  uremia,  stone,  gout,  or  arthritis  the 
prohibition  of  its  use  should  be  tempered  with 
discretion. 

In  acute  diseases  soup  may  be  given  in  small 
doses  in  types  of  general  asthenia,  but  it  should 
be  forbidden  at  once  if  symptoms  of  plethora 
and  congestion  be  observed. 

JUICE    OF    MEAT 

This  approaches  the  composition  of  meat 
much  more  than  soup.  Although  less  nourish- 
ing, it  possesses  all  its  qualities,  and  is  a  regular 
muscle-builder.  For  consumptives  it  is  a  valu- 
able food,  because,  according  to  Richet,  all  the 
antitoxic  components  of  the  meat  enter  into  the 
juice  if  the  pressure  is  sufficiently  strong.  Two 
hundred  grams  of  raw  mutton  should  be  forced 
through  a  meat-press.  The  juice  thus  extracted 


74  WHAT  SHALL  I    EAT? 

may  be  consumed  either  at  the  beginning  or  in 
the  middle  of  the  meal,  or  it  may  be  mixed  with 
the  food.  It  may  be  taken  by  itself  fresh  or 
lukewarm,  but  it  must  be  heated  or  boiled  for 
fear  of  losing  its  therapeutic  properties.  In 
convalescent  hypopeptic  or  nervous  persons,  and 
in  cases  of  chronic  gastritis,  meat- juice  will  of- 
ten stimulate  the  gastric  functions — in  fact,  the 
whole  system. 

There  is  a  large  number  of  commercial  arti- 
cles which  are  prepared  in  ever  so  many  different 
ways,  the  principal  advantage  of  which  is  sim- 
ply one  of  commodity. 

EXTRACT   OF    BEEF 

The  best  known  of  these  is  Liebig's  Extract, 
so  called  after  the  famous  German  chemist.  It 
is  made  by  evaporization  under  pressure.  The 
fat  is  removed  by  filtration,  and  the  liquid  is 
condensed  in  a  vacuum  pan,  also  under  pressure, 
until  it  attains  the  consistence  of  a  thick  syrup. 
This  method  extracts  all  vestiges  of  fat  and  a 
goodly  portion  of  gelatin.  With  the  exception 
of  this  difference,  meat  extracts  possess  all  the 
good  as  well  as  the  bad  properties,  indications, 
and  contraindications  of  soup;  they  are  equally 


MEAT  75 

rich  in  xanthic  matter.  It  may  be  of  interest 
to  give  here  the  formula  of  v.  Liebig,  the  fa- 
mous German  chemist,  for  making  a  beef -juice 
from  fresh  beef: 

Hydrochloric  acid  (dilute) 30  minims  (drops) 

Water i  to  |  pint 

Table  salt 1  saltspoonful 

Rump-steak,  cut  into  small  cubes .  .  .  f  pound 

Soak  for  one  hour.  Strain  through  muslin  cloth. 
Serve  cold.  Use  a  porcelain,  glass,  or  horn  spoon.  It 
will  stain  silver  or  any  other  kind  of  metal. — (Translator.) 

MEAT   POWDER 

Albumin 69.50 

Fat 5.85 

Carbohydrates 0.00 

Ash 13.25 

Available  calories  —  313 

Meat  powder  is  very  nitrogenous,  but  is  a  food 
of  high  value.  It  is  manufactured  in  large 
quantities  from  dried  meat  reduced  to  a  powder. 
It  may  be  made  at  home  by  scraping  the  meat 
with  a  knife  into  a  pulp,  which  is  then  allowed 
to  dry  in  a  steamer  placed  on  a  hot  metal  plate. 
This  should  be  slightly  inclined,  so  as  to  al- 
low the  fat  to  separate.  Finally,  it  should  be 


76  WHAT   SHALL   I    EAT? 

pounded  in  a  mortar.  But  it  is  well  to  bear  in 
mind  that  it  spoils  quickly  and  grows  rancid. 

Meat  powder  is  put  to  many  therapeutic 
uses. 

It  is  a  food  easy  to  digest,  and  will  quickly 
restore  losses  in  nitrogen.  It  may  be  added 
with  advantage  to  other  foodstuffs,  such  as 
soup  or  milk.  Emulsified  with  a  small  quantity 
of  mineral  water  it  may  be  administered  with 
the  stomach-pump.  As  a  sedative  in  gastric 
troubles  it  is  highly  recommended.  Excellent 
results  have  been  obtained  with  it  in  hyper- 
chlorhydria.,  in  cases  of  denutrition,  phthisis, 
gastric  hyperesthenia,  and  obstinate  vomiting. 

PEPTONES 

The  peptones  are  produced  by  the  digestion  of 
muscular  meat,  either  by  the  aid  of  papain  in 
the  hydrochloric  fluid,  or  by  pancreatin  in  a 
solution  of  carbonate  of  soda.  There  has  been 
much  controversy  about  its  alimentary  value; 
but  the  question  seems  to  have  been  finally  set- 
tled in  the  affirmative.  Among  the  subjects 
discussed  was  the  balance  of  nitrogen.  It  was 
shown  that  up  to  69  per  cent  of  the  usual  albu- 
minoids could  be  replaced  by  their  weight  with 


MEAT  77 

peptones  without  disturbing  the  balance  of 
nitrogen.  —  (Gautier. ) 

The  true  peptones  are  but  seldom  ingested  by 
way  of  the  mouth.  They  are  chiefly  adminis- 
tered by  means  of  rectal  injections  for  nutritive 
purposes.  When  carefully  emulsified  with  bouil- 
lon, milk,  or  even  wine,  with  the  addition  of  4 
to  5  drops  of  laudanum,  they  are  well  tolerated, 
absorbed,  and  assimilated  by  the  system. 

In  all  cases  where  feeding  by  the  mouth  is 
impossible  or  objectionable  (in  esophagous  ste- 
nosis, gastric  ulcers,  incorrigible  vomiting)  these 
injections  should  be  given.  They  will  often 
sustain  the  patient  for  weeks. 

If  by  the  mouth  they  are  generally  taken  in 
the  shape  of  peptonic  preparations,  commercial 
articles  which  are  principally  composed  of  albu- 
min and  albumose,  and  contain  but  a  small 
fraction  of  peptones.  Among  these  we  mention 
plasmon,  which  is  composed  of: 

Albuminoids.  Fat.  Carbohydrates.  Ash. 

74.5  1.7  0  0.3 

The  available  calories  are  about  350,  but  as 
intestinal  absorption  is  frequently  imperfect, 
this  number  is  correspondingly  diminished. 

Some  of  the  preparations,  for  instance,  pepton 


78  WHAT  SHALL   I    EAT? 

Kemmerich  and  somatose,  are  produced  from 
muscular  meat;  others  from  the  albumin  of 
milk  (plasmon  and  sanatogen),  while  tropon  is  a 
mixture  of  animal  and  vegetable  albumin.  All 
these  substances  have  so  far  fallen  short  in  actual 
practice  of  the  results  claimed  for  them.  Re- 
quiring no  mastication,  leaving  no  residue  and 
easily  causing  putrefaction,  they  often  enough 
become  irritants  to  the  stomach  and  the  bowels. 
Besides  they  have  the  disadvantage  of  being 
almost  purely  nitrogenous.  Pepton  Kemmer- 
ich and  plasmon  are  perhaps  the  best  among 
them. 

They  should  never  be  made  the  basis  for 
nutrition,  should  never  be  taken  in  large  doses, 
but  only  for  the  purpose  of  raising  the  level 
of  the  alimentary  ratio.  They  prove  useful  in 
cases  of  insufficiency  of  nutrition,,  in  cancer,  re- 
peated attacks  of  vomiting,  anemia,  and  for  feed- 
ing up  phthisical  persons.  With  prudence  and 
discretion  they  may  be  employed  to  advantage 
in  dyspepsia,  cardiac  affections,  and  Bright' s  dis- 
ease. But  in  cases  of  enteritis  or  enterocolitis 
their  use  must  be  strictly  forbidden. 


FISH 

IN  respect  to  hygiene  of  food,  fish  proves  a 
rather  heterogeneous  group.  The  great  differ- 
ence in  the  composition  of  the  various  species  of 
fish  entails  a  corresponding  variety  of  properties 
and  organic  reactions.  We  have,  therefore, 
decided  to  divide  them  into  two  classes  by  set- 
ting aside  the  usual  division  into  salt-water  and 
fresh-water  fish,  i.e.,  less  fatty  fish  andfattyjish, 
a  better  physiological  classification,  we  think, 
than  the  former,  which  also  renders  it  easier  to 
point  out  the  indications  and  contraindications. 
We  shall  study  the  first  class  according  to  our 
usual  plan.  For  the  second  class  we  shall  con- 
tent ourselves  with  simply  pointing  out  the 
differences. 

The  crustaceans,  mollusks,  and  shell-fish  will 
be  considered  in  a  separate  chapter.  These  de- 
serve special  mention,  for  in  certain  districts 
they  form  an  important  part  of  the  diet  of  the 
inhabitants.  (See  pages  88-92. ) 

79 


80  WHAT  SHALL   I    EAT? 

LESS  FATTY  FISH 

BASS,     PIKE,     CARP,     COAL-FISH,    GOLDFISH,     SMELT,    GUDGEON, 

BULLHEADS,   CODFISH   (FRESH),  WHITING,    PERCH,    PLAICE, 

SKATE,   CATFISH,  SARDINES   (FRESH),  TROUT 

COMPOSITION — ALIMENTARY   VALUE 

Albumin 18.00 — Purin. .    0.057 

Fat 1.35— Chlorid  0.07    (fresh- water  fish) 

Carbohydrates.      0.00—     "          0.50    (salt-water  fish) 

Ash 1.07 

Available  calories  =  82 

We  have  put  together  in  this  group  all  those 
in  whom  the  percentage  of  fat  varies  from  0. 50 
to  3  per  cent.  The  figures  given  represent  the 
average  composition  of  the  sixteen  kinds  of  fish 
enumerated. 

So  far  as  the  nitrogenous  element  is  concerned 
fish  strongly  approaches  beef.  The  xanthic 
valids  are  in  favor  of  fish,  excepting  which  the 
flesh  of  fish  has  the  same  nutritive  value  as 
meat.  Rosenfeld,  after  numerous  experiments, 
came  to  the  conclusion  that  fish  gives  the  same 
satisfaction  as  meat,  allows  of  the  same  utiliza- 
tion of  forces  by  the  navvy,  the  sportsman,  the 
soldier  as  well  as  by  those  who  lead  a  sedentary 
life.  Many  people,  for  instance  the  Japanese, 


FISH  81 

live  almost  exclusively  on  fish,  and  but  rarely 
eat  meat.  Nothing  can  explain  the  prejudice 
which  so  many  people  have  against  this  article 
of  food.  If  fish  is  a  little  deficient  in  stimula- 
ting quality,  naught  but  good  can  come  from 
its  use  to  the  system. 

In  the  variety  under  observation,  fat  is  pres- 
ent in  small  quantities  only,  which,  of  course, 
reduces  the  caloric  value.  It  is  a  fluid  fat,  how- 
ever, rich  in  olein  and  organic  phosphorus. 

Mineral  substances  are  present  in  smaller 
quantities  than  in  meat.  Phosphorus  predomi- 
nates, and  fish  may  be  styled  a  rephosphorating 
food.  Lime  and  magnesia  are  found  in  rather 
large  proportion;  of  iron  there  is  scarcely  a 
trace.  Salt  is  very  scant  in  fresh-water  fish, 
but  very  abundant  in  salt-water  fish. 

METHODS   OF    PREPARATION 

Fish  is  served  either  fried  or  baked  or  boiled, 
with  or  without  sauce.  The  frying  process,  the 
white  sauces,  and  the  mayonnaise  add  the  fat 
which  is  wanting,  but  add  also  to  the  troubles 
of  digestion.  Dyspeptics  should  give  fish  the 
preference  over  soup  and  white  meat;  but  if 
they  eat  fish  fried,  they  should  only  partake 


82  WHAT  SHALL   I    EAT? 

of  the  meat  of  the  fish  and  leave  the  fat  on 
the  plate.  The  custom  to  eat  potatoes  with 
fish  has  a  practical  value,  as  it  supplies  the 
want  of  carbohydrates. 

REACTIONS 

a.  Digestive.  — The  meat  of  the  less  fatty  fish 
is  tender  and  delicate,  easy  to  digest,  does 
not  excite,  and  passes  quickly  through  the 
stomach.  It  seems  to  favor  fermentation  less 
than  muscular  meat,  but  it  must  always  be 
absolutely  fresh. 

This  question  of  absolute  freshness  in  fish  is  of 
great  importance.  It  is  an  essential  quality,  on 
which  depend  to  a  large  extent  its  dietetic 
properties. 

Absolutely  fresh  fish  will  never  cause  any  in- 
convenience, but  if  it  is  spoiled  even  in  the 
slightest  degree,  it  becomes  risky.  Unfortu- 
nately putrefaction  sets  in  with  incredible  rapid- 
ity, quite  unknown  in  other  articles  of  food, 
excepting  shell  fish;  in  the  summer-time  it 
requires  but  a  few  hours.  The  packing  in  ice  is 
only  a  palliative,  which  frequently  serves  merely 
to  mask  the  odor.  In  fact,  a  sort  of  maceration 
is  produced  in  the  water  of  the  melting  ice, 


FISH  83 

which  accelerates  decomposition  when  access  of 
air  is  permitted.  In  the  summer  months  it  is, 
practically  speaking,  well-nigh  impossible  to 
obtain  fresh  salt-water  fish  anywhere,  except  at 
the  seaside  itself. 

The  danger  is  the  greater,  because  the  odor 
betrays  putrefaction  only  in  its  advanced,  and 
not  in  its  incipient  stage. 

b.  General.  — This  differs  but  little  from  that 
of  meat,  since  the  action  is  the   same  as  that 
of    any   other    nitrogenous  foodstuff.     But  the 
scarcity  of  purin  reduces  the  exciting  influences 
on  the  heart  and  blood-vessels,  and  consequently 
on  the  whole  system. 

Attention  is  called  here  to  the  fact  that  cer- 
tain lake  fish,  especially  of  the  Lake  of  Geneva 
and  of  Annecy  may  cause  infection  of  bothrio- 
cephalus  latus  (broad  tapeworm). 

c.  Eliminating. — Reaction   on   the   intestines 
depends  entirely  on  the  state  of  preservation  of 
the  fish.     When  quite  fresh  it  has  but  a  slight 
toxic    effect   on   the   renal    glands;     but,  when 
spoiled,  it  fatigues   the  kidneys  and  may   be- 
come a  source  of  danger. 


84  WHAT  SHALL   I    EAT? 

INDICATIONS   AND   CONTRAINDICATIONS 

Fish  constitutes  the  world  over  an  excellent 
diet,  possessing  the  same  advantages  as  meat, 
without  its  objectionable  features.  As  a  popu- 
lar food  the  less  fatty  fish,  however,  must  give 
way  to  the  fatty  fish,  which  are  certainly  more 
nourishing;  but  the  former  are  ever  preferable 
in  pathological  conditions. 

That  is  the  reason  why  they  agree  so  well 
with  dyspeptics  and  in  hypo-  or  hyperchlorhydria. 
It  is  advisable  to  eat  the  fish  before  the  meat,  as 
it  assists  the  transitional  process  from  the  lacteal 
to  the  ordinary  regimen.  It  must  not  be  pre- 
pared with  hot  butter  or  fat,  and  must  be  abso- 
lutely fresh.  There  are  dyspeptics  who  cannot 
digest  fish  bought  in  the  city,  but  who  tolerate 
a  fish  diet  perfectly  when  at  the  seaside.  In 
cases  of  intestinal  trouble  and  under  similar 
conditions  it  affords  more  comfort  than  meat. 

It  pleases  the  weak  stomach  of  the  convales- 
cent, inasmuch  as  its  richness  in  phosphorus  and 
mineral  substances  renders  it  useful. 

In  arthritis  and  for  obesity  it  may  be  well 
recommended  as  a  change  and  a  means  to  react 
on  the  abuses  of  the  meat  diet. 


FISH  85 

In  albuminuria  it  is  generally  held  to  be 
injurious.  Teissier  considers  it  a  food  criterion 
of  recovery,  if  fish  can  be  eaten  without  showing 
an  increase  or  reappearance  of  albumin.  Dar- 
emberg  claims  that  a  fish  diet  (absolutely  fresh) 
is  not  only  inoffensive,  but  very  useful  in  the 
treatment  of  albuminuria,  in  fact  apt  to  bring 
about  a  genuine  cure. 

We  believe  also  that  eczematous  persons  have 
nothing  to  fear  from  feasting  on  less  fatty  fish 
fresh  from  the  water. 

FATTY  FISH 

SHAD,  EEL  (FRESH  WATER),  HERRING,  MACKEREL,  SALMON, 
TUNNY  (SPANISH  MACKEREL),  TURBOT,  MULLET 

Albumin 18.50 

Fat 11.50— Purin  .  .    0.13  (salmon) 

Carbohydrates  .     0. 00 — Chlorid .    0. 07  (fresh- water  fish) 

Salts 0.87—  0.50  (salt-water  fish) 

Available  calories  =169 

The  percentage  of  fat  is  below  that  of  meat, 
fluctuating  between  5  and  13  per  cent,  except  in 
the  eel  where  it  reaches  26  per  cent.  It  varies, 
however,  not  only  according  to  species,  but  also 
with  the  season  of  the  year  in  the  same  species. 


86  WHAT  SHALL   I    EAT? 

The  fatty  fish  are  more  nourishing  than  the 
less  fatty,  also  more  nitrogenous,  though  poorer 
in  mineral  substances,  but  much  richer  in  puric 
bases. 

They  are  heavier  on  the  stomach,  as  their 
flesh  is  firmer  and  more  compact.  Even  when 
quite  fresh  they  are  apt  to  cause  gastric  and 
intestinal  fermentation,  and  this  objectionable 
feature  is  frequently  intensified  by  the  greasy 
and  rich  sauces  which  are  served  with  them. 

The  action  on  nutrition,  on  the  circulation 
and  on  the  renal  system,  depends  on  the  richness 
in  purins  which  make  them  almost  the  equiva- 
lent of  meat.  We  draw  attention  to  the  fact 
that  the  fresh  serum  of  the  eel  has  a  toxic  effect 
on  the  kidneys. 

For  these  important  reasons  the  use  of  fatty 
fish  is  contraindicated  in  all  cases  in  which  the 
less  fatty  fish  may  be  recommended.  In  dyspep- 
sia, gastric  as  well  as  intestinal,  in  arthritis, 
obesity,  cardiac  ailments,  Bright' s  disease,  and 
eczema  their  use  will  always  prove  harmful.  To 
this  list  may  be  added  liver  complaints,  uremia, 
gout,  and  stone.  There  are  circumstances,  how- 
ever, under  which  they  prove  superior,  for  they 
are  a  valuable  food  for  the  normal,  healthy 


FISH  87 

human  beings,  and  especially  so  for  the  poorer 
classes.  In  a  piece  of  beef  cut  from  the  neck — 
one  of  the  cheaper  cuts — one  gram  of  nitrogen 
costs  about  12  cents,  and  100  calories  about  17 
cents.  A  fresh  herring  costs  about  3j  cents. 
Fatty  fish,  moreover,  may  constitute  a  complete 
diet;  that  is  to  say,  they  may  represent  the  only 
supply  of  food  available  for  an  entire  race 
(Esquimaux). 

In  diabetes  they  are  of  great  service  on  account 
of  their  high  nutritive  power  and  the  absence  of 
carbohydrates,  although  their  use  may  even 
here  be  contraindicated  by  reason  of  other  com- 
plications. 

They  should  figure  frequently  on  the  table  of 
consumptives. 

Boiled  fish  with  mayonnaise,  sardines  in  oil 
crushed  into  a  paste  with  butter  and  hard-boiled 
eggs,  are  most  nourishing  foods,  rich  in  fat,  and 
easily  tolerated  by  the  stomach,  especially  dur- 
ing the  heated  term  of  the  year. 


88  WHAT  SHALL   I    EAT? 

CRUSTACEANS  AND    SHELL-FISH 

The  crustaceans,  mollusks,  and  shell-fish,  oc- 
cupy by  no  means  a  secondary  place  in  the  list 
of  our  foodstuffs,  and  perhaps  justly  so.  We 
shall  be  brief  in  our  remarks  about  this  variety, 
which  are  considered  to  be  often  more  harmful 
than  beneficial. 

Carbo-  Available 

Albumin.  Fat.         hydrates.       Salt.          Calories. 

Prawns,  shrimps..  25.83  1.57  0  3.32  128 

Crabs 15.30  0.46  0  1.01  71 

Lobsters 18.85  1.01  0  1.85  92 

Oysters 9.71  1.14  0  1.62  53 

Mussels 13.60  1.09  0  1.20  70 

It  is  apparent  that  this  category  of  food  is  rich 
in  nitrogen,  especially  prawns  (shrimps).  Xan- 
thic  substances  also  abound,  particularly  in  the 
crab  and  in  snails.  Fat  is  most  prominent  by 
its  absence  (lobster).  But,  as  if  by  way  of  com- 
pensation, they  are  foods  strongly  mineralized. 
This,  however,  is  again  minimized  by  the  fact 
that  salt  is  present  to  such  a  large  degree. 

Snails  deserve  special  mention  here,  as  in 
some  countries  they  are  consumed  in  large  quan- 
tities. They  are  a  hard,  tough,  indigestible 
substance,  which  must  be  made  piquant  by  the 
addition  of  spicy  condiments  to  excite  the 


FISH  89 

stomach.  They  are  unfit  for  the  sick-room, 
and  present  no  advantage  whatever  to  the  hale 
and  hardy. 

Lobster,  grayfish,  and  crab  also  have  a  hard, 
compact  meat,  and  are  difficult  to  digest. 
They  are  powerful  excitants  and  full  of  toxins, 
not  infrequently  causing  eruptions  on  the  skin, 
nettlerash  (urticaria),  vomiting,  and  diarrhea. 
Dyspeptics  should  never  touch  them,  and  they 
should  be  barred  from  the  menu  in  cardiac  or 
in  Bright' s  disease,  in  arthritis,  and  in  eczema. 

Shrimps  and  prawns  are  less  dangerous;  the 
meat  is  more  delicate  and  rather  rich  in  mineral 
matter,  mainly  phosphorus;  the  taste  is  refined 
and  piquant,  which  justifies  their  use,  especially 
during  the  summer  months,  for  the  purpose  of 
whetting  a  sluggish  appetite.  Moreover,  they 
have  the  advantage  of  being  eatable  without 
sauce  or  other  bothersome  additions.  They 
must  not  be  consumed  in  heart  or  in  Bright' s 
disease,  nor  in  eczema.  Dyspeptics  and  those 
afflicted  with  arthritis  should  not  eat  them,  ex- 
cept once  in  a  great  while.  But  to  anemic,  con- 
valescent, and  consumptive  persons  they  may  be 
recommended. 

Oysters   and   mussels   resemble   each   other  a 


90  WHAT  SHALL   I    EAT? 

good  deal;  in  fact,  the  mussel  might  be  styled 
the  oyster  of  the  poor.  Being  less  nitrogenous, 
they  are  easy  to  digest.  They  carry  no  undue 
excitement  to  the  gastric  regions,  and  do  not 
fatigue  them.  Gautier  considers  them  genuine 
condiments.  The  reaction  on  the  general  sys- 
tem, and  particularly  on  the  kidneys,  is  fa- 
vorable. Still,  there  are  objectionable  features 
connected  with  them,  as  they  frequently  harbor 
intoxication  and  infection. 

Ptomain-poisoning,  which  manifests  itself  in 
the  same  manner  as  in  spoiled  meat,  i.e.,  by 
gastrointestinal  intolerance  and  by  dermic  erup- 
tions and  headaches,  is  by  no  means  of  infre- 
quent occurrence  with  mussels  as  well  as  with 
oysters.  Their  pathogenic  properties  have  been 
the  subject  of  much  research  during  recent 
years.  They  are  undoubtedly  due  to  certain 
changes  which  take  place  in  the  liquor  of  the 
oyster,  a  truly  living  organic  liquid.  As  in 
fish,  these  changes  take  place  very  rapidly,  par- 
ticularly with  a  rising  temperature,  and  the 
toxicity  increases  in  the  same  proportion. 

Twenty  hours  after  the  oyster  has  been  taken 
from  its  bed  it  requires  44  c.c.  of  its  liquor  to 
every  two  pounds  of  body  weight  of  the  victim 


FISH  91 

to  kill  a  rabbit;  after  two  days  at  65°  Fahren- 
heit it  takes  only  14  c.c.,  and  after  three  days, 
at  75°  Fahrenheit,  only  6  c.  c.  —  (Say lac. ) 

It  is  easy  to  understand  the  wisdom  of  the  old 
saw:  "  Abstain  from  oysters  during  the  months 
which  have  no  V  in  them,"  i.e.,  May  to 
August,  on  account  of  the  high  temperature 
prevailing  during  that  period. 

The  infection  which  seems  to  be  more  pre- 
dominant in  the  oyster  than  in  the  mussel,  is 
ascribed  to  the  presence  of  pathogenic  micro- 
organisms. Typhoid,  cholera,  and  Eberth's 
bacillus  have  been  found  in  it.  The  cause  of 
the  disease  in  the  patient  can  be  traced  beyond 
doubt  to  the  consumption  of  these  mollusks. 
The  trouble  is  evidently  due  to  the  bad  location 
of  the  oyster-beds,  which  not  infrequently  are 
too  near  the  outfall  of  sewage.  The  attention 
of  the  proper  authorities  has,  however,  been 
called  to  these  defects,  and  in  many  countries 
the  oyster-beds  have  been  placed  under  the 
surveillance  of  government  inspectors,  by  which 
means  much  of  the  danger  has  been  removed. 
Nevertheless,  it  is  wise  never  to  lose  sight  of  the 
facts  quoted  above. 

Mussels  and  oysters  should  not  be  eaten  by 


92  WHAT  SHALL   I    EAT? 

those  whose  intestines,  kidneys,  or  skin  do  not 
function  properly.  Their  peptogenic  value, 
their  richness  in  mineral  substances  and  rare 
metalloids,  such  as  iodin  and  bromin,  make 
them  serviceable  for  building  up  enfeebled  con- 
stitutions. Convalescents,  and  those  run  down 
by  disease,  will  be  benefited  by  their  use.  The 
same  holds  good  for  cancer,  tuberculosis,  and 
dyspepsia,  in  hyperchlorhydria  and  glycosuria. 
For  the  latter  disease  particularly  they  possess, 
according  to  Bouchardat,  a  definite  therapeutic 
value. 


MILK 

IN  milk  we  find  a  new  alimentary  constituent, 
and  perhaps  the  most  important  of  them  all  at 
any  rate  so  far  as  quantity  is  concerned.  We 
refer  to  the  carbohydrates  which  are  missing 
almost  entirely  in  all  of  the  foods  described  so 
far.  The  presence  of  this  element  makes  milk 
form  a  natural  transition  from  the  rich  regimen, 
composed  chiefly  of  albumin  and  fats,  to  the 
vegetarian  regimen,  in  which  the  fats  almost 
entirely  disappear  and  the  nitrogenous  content 
is  diminished,  thus  leaving  the  carbohydrates 
in  a  predominant  position.  And  it  cannot  be 
otherwise,  for  milk  is  in  itself  a  complete  nutri- 
ment, at  any  rate  so  far  as  the  earlier  months  of 
life  are  concerned;  later  on  the  bad  proportion 
of  its  constituent  compounds,  especially  the  in- 
sufficient quantity  of  certain  mineral  bodies, 
prevent  it  from  being  adequate  to  the  wants  of 
our  organism.  This  is  at  once  apparent  when 
an  adult  is  by  necessity  restricted  to  a  rigid 
milk  diet.  Milk,  besides  fruits,  has  always 

93 


94  WHAT  SHALL   I    EAT? 

been  one  of  the  principal  foods  of  the  human 
species. 

From  the  medical  standpoint  its  importance 
consists  chiefly  in  its  dietetic  and  therapeutic 
value,  inherent  in  its  own  essence  or  present  in 
its  derivatives,  for  cases  of  illness  in  which  it 
may  be  employed  either  as  a  vehicle  or  as  a 
means.  An  enormous  number  of  problems 
come  here  into  consideration  which  interest  not 
only  the  physician,  but  the  hygienist  and  the 
sociologist  alike. 

COMPOSITION   AND   FOOD   VALUE 

The  composition  of  milk  differs  in  every  spe- 
cies of  mammals.  And  again  it  varies  in  each 
species  with  the  age  of  the  individual  animal, 
and  according  to  the  period  of  lactation.  It 
also  depends  on  the  physical  condition,  i.  e. ,  the 
state  of  health  of  the  individual  animal,  on 
stabling,  grooming,  surroundings,  nature  and 
method  of  feeding.  The  best  that  we  can  do  is 
to  give  the  average  or  mean  composition  of  milk 
of  each  species,  basing  our  calculations  upon 
scientific  experiments  and  analyses  given  by 
recognized  authorities  for  different  kinds  of  milk 
used  for  domestic  purposes. 


MILK  95 

COW'S   MILK 

Albumin 3.28 

Fat 3.48— Chlorid  .  .  .    0.15 

Carbohydrates..    4.82 — Purin 0.056 

Ash 0.53 

Available  calories  =182 

The  density  is  about  1032.  The  figures  given 
above  do  not,  however,  represent  a  standard  by 
which  adulterations  may  be  detected.  They  are 
also  somewhat  below  those  usually  quoted,  but 
we  wish  to  point  out  that  we  are  dealing  here 
with  substances  already  in  the  process  of  di- 
gestion. 

Milk  is  essentially  composed  of  an  opalescent 
plasm,  in  which  myriads  of  butyric  globules  of 
^  to  ^  m.  m.  in  diameter  are  held  in  suspen- 
sion. This  plasm  holds  albuminoid  substances 
in  a  more  or  less  complete  state  of  solution;  also 
a  special  kind  of  sugar  and  different  kinds  of 
salt.  For  the  better  understanding  of  the  sub- 
ject we  quote  Gautier:  "There  are  two  kinds  of 
bodies  held  in  suspension  in  the  plasm  of  milk, 
viz. :  1.  Globules  of  butter  which  seem  to  con- 
tain an  infinitesimally  small  amount  of  fatty 
substance  encapsuled  in  a  very  thin,  elastic 


96  WHAT  SHALL   I    EAT? 

envelope  composed  of  proteid  matter.  There 
are  about  1,500,000  of  these  little  balloons  to 
the  cubic  millimeter.  2.  Fine  granulations 
of  phosphates  which  are  united  in  a  special  albu- 
minoid nuclein  substance. ' ' 

The  albumins  of  the  plasm,  which  may  form 
from  1.5  to  5.5  per  cent,  are  casein  and  lacto- 
albumin.  The  first  is  found  in  a  state  of  demi- 
dissolution.  The  lab -ferment,  together  with 
the  pressure  of  the  stomach,  precipitates  the 
acids  into  a  clot  (cheese),  which  becomes  the 
more  compact  the  stronger  the  acids  are.  This 
coagulation,  like  that  of  blood,  is  facilitated 
by  the  addition  of  salts  of  lime.  The  casein 
is  peptonized  by  the  aid  of  pepsin,  and  leaves 
an  indissoluble  residue,  composed  of  nuclein  and 
phosphorized  paranuclein. 

The  lactoalbumin  is  suspended  in  the  serum 
after  caseation,  and  does  not  coagulate  under 
heat. 

Butter  is  the  principal  constituent  of  milk, 
and  controls  the  food  value.  Large  institutions, 
especially  hospitals  in  Europe,  pay  for  the  milk 
they  use,  according  to  the  proportion  of  butter 
contained  in  it,  which  varies  from  30  to  82 
grams  per  liter.  It  is  formed  by  the  coalescence 


MILK  97 

of  the  fatty  substances  contained  in  the  butyric 
globules.  To  obtain  it,  the  milk  is  allowed  to 
stand,  when  a  layer  of  cream,  composed  of  these 
globules,  forms  on  the  top.  The  cream  is  taken 
off  and  churned,  by  which  process  the  thin  cov- 
erings of  the  albumin  are  broken,  thus  allowing 
the  masses  of  butter  to  unite  and  assume  a  solid 
appearance.  The  skimmed  milk,  although  de- 
prived of  the  fats,  is  used  for  many  purposes  and 
quite  fit  for  consumption.  At  any  rate,  in  large 
cities  it  is  difficult  to  obtain  any  other  but  partly 
skimmed  milk.  Although  it  is  not  as  nourish- 
ing as  whole  milk,  it  is  preferable  in  many  dis- 
eases in  which  the  patient  can  digest  it  with 
more  ease.  What  is  left  behind  in  the  churning 
is  called  buttermilk,  an  article  of  food  which  pos- 
sesses excellent  therapeutical  properties,  to  which 
we  shall  revert  later  on. 

The  third  nutritive  element  of  milk  is  the 
carbohydrates,  i.  e. ,  lactose  or  milk  sugar.  This 
is  a  bihexose,  well  known  for  its  diuretic  prop- 
erties, which  makes  the  sugar  in  diabetics. 

The  oscillations  are  a  little  less  accentuated, 
varying  between  3.50  grams  and  5  grams  per 
liter. 

The  mineral  substances  are  relatively  abun- 


98  WHAT  SHALL   I    EAT? 

dant,  furnishing  about  the  twentieth  part  of  the 
dry  extract.  They  are  not  readily  absorbed  by 
the  bowels. 

While  it  shows  98. 8  of  albumin,  94. 5  of  but- 
ter, and  100  of  lactose,  33. 8  of  the  salts  in  chil- 
dren and  49.6  in  the  adult  are  not  utilized. 
For  this  reason  milk  cannot  be  counted  among 
the  best  mineralizing  foods.  Two  elements  are 
predominant,  viz. :  lime  and  phosphorus;  the 
former  to  the  extent  of  1.60  grams  per  liter. 
Because  this  is  not  readily  absorbed,  being  pres- 
ent chiefly  in  the  shape  of  phosphate  of  lime 
(but  slightly  soluble),  and  because  in  infants 
three-fourths  of  it  is  rejected,  milk  cannot  lay 
claim  to  being  a  first-class  vehicle  for  alimentary 
chalk. 

Phosphorus  is  also  abundant,  and  is  present 
chiefly  in  the  shape  of  physiological  values  well 
differentiated;  one  portion  envelops  the  casein 
under  the  form  of  nuclein;  a  second  portion  is 
present  in  the  shape  of  lecithin  analogous  to  that 
contained  in  eggs  to  the  extent,  in  the  mean, 
of  1  gram  per  liter.  The  rest  is  represented  by 
phosphocarnic  acid,  or  nuclein. 

Gautier  insists  that  the  principal  role  of  this 
phosphocarnic  acid  is  to  act  as  an  agent  in  the 


MILK  99 

assimilation  of  phosphorus,  lime,  and  iron  by 
the  economy.  Cows'  milk  is  unfortunately  not 
well  supplied  with  this  agent,  phosphorus,  in  the 
shape  of  nuclein,  representing  only  6  per  cent  of 
the  total  amount  of  phosphoric  content. 

It  is  well  to  bear  in  mind  that,  if  the  absorp- 
tion of  phosphorus  is  defective  when  milk  is 
taken  raw,  it  is  still  more  so  when  it  has  been 
boiled  or  heated  for  some  time,  as  this  process 
separates  a  part  of  the  lecithin  while  producing 
phosphates.  As  a  phosphorating  food  milk  is 
only  of  medium  value. 

Of  other  elements  there  are  only  a  few:  mag- 
nesium is  rare,  sodium  chlorid  about  1.50  per 
liter,  iron  about  0.004  gram. 

Milk  is  essentially  a  living  food.  It  contains 
a  number  of  diastasic  ferments,  viz. :  oxydase, 
yeasts  giving  solubility  to  the  casein,  and 
hydrolyzing  amidin.  Our  knowledge  of  these  is 
at  present  very  limited,  but  their  usefulness  in 
the  process  of  nutrition  is  unquestionable. 


100  WHAT   SHALL   I    EAT? 

MOTHER'S   MILK 

Albumin 1.84  (  — ) 

Fat 3.52  (  +  )  Chlorid  .  .  .  0.05 

Carbohydrates.  .    6. 11  (  +  ) 

Ash 0.23  (-) 

Available  calories  =  66 

Its  composition  changes  somewhat  toward  the 
thirtieth  year;  a  little  later  on  it  is  less  mineral- 
ized. Abundant  feeding  increases  the  amount 
of  butter  and  sugar;  underfeeding  diminishes 
the  amount  of  casein  and  of  butter.  Nitrogen 
declines  during  the  period  of  lactation;  butter 
and  lactose  vary  but  little. 

Aside  from  the  changes  that  take  place  in  the 
distribution  of  nitrogen  and  the  ternary  bodies 
which  we  have  indicated  by  +  and  — ,  mother's 
milk  possesses  certain  qualities  which  make  it 
differ  from  and  superior  to  cow's  milk. 

1st.  Casein  is  precipitated  in  finer  and  more 
granular  floccules.  Its  digestion  leaves  no  resi- 
due of  nuclein. 

2d.  The  absorption  of  the  mineral  substances 
is  more  perfect — 80  per  cent  for  the  whole  of 
the  salts,  60  per  cent  for  the  lime,  and  92  per 
cent  for  phosphorus.  —  (Michel  and  Perret.) 

3d.   Phosphorus  is  present  in  its  organic  state. 


MILK  101 

The  following  table,  in  which  the  amount  of 
phosphorus  per  liter  is  given,  will  show  the 
difference. 

Organic  Phosphorus.       Phosphate  of  Casein. 

Mother's  milk 0.320  0.132 

Cow's  milk 0.180  0.580 

4th.  Although  up  to  the  present  time  no 
definite  proof  of  their  existence  has  been  ad- 
vanced, yet  clinical  facts  force  us  to  admit  the 
presence  in  mother's  milk  of  certain  specific 
ferments  which  not  only  facilitate  its  digestion 
and  absorption,  but  also  the  assimilation  and 
fixation  of  the  substances  in  the  organism.  It 
is  also  possible  that  their  specificity  is  better 
adjusted,  and  that,  thanks  to  them,  the  moth- 
er's milk  agrees  so  much  better  with  the  infant. 

ASS'S  MILK 

Albumin 1.79 

Fat 1.30 

Carbohydrates 6.07 

Ash 0.35 

Available  calories  =  44 

This  approaches  more  than  any  other  in  qual- 
ity the  mother's  milk.  It  is  very  easy  to  digest. 
Casein  is  precipitated  in  fine  floccules  and  leaves 
no  residue  of  nuclein. 


102  WHAT  SHALL   I    EAT? 

It  is  a  valuable  food,  especially  for  irritable 
and  shattered  stomachs.  It  causes  no  inconve- 
nience. As  it  is  subject  to  rapid  changes,  it  must 
be  consumed  soon  after  it  has  been  drawn.  It 
will  keep  fresh  for  a  few  hours  only,  but  before 
being  consumed  should  be  warmed  up  to  100° 
Fahrenheit. 

Mare's  milk  possesses  pretty  well  the  same 
qualities  and  composition,  but  is  difficult  to  ob- 
tain in  almost  any  country.  It  comes  on  the 
market,  however,  under  the  name  of  koumys 
(see  page  131). 

GOAT'S   MILK 

It  is  superior  to  cow's  milk,  as  it  is  richer  in 
casein,  butter,  and  mineral  matter. 

METHODS  OF   PREPARATION   AND    HOW   TO   USE  MILK 

The  most  natural  and  cheapest  method  of 
using  milk  has  always  been  to  drink  it  raw. 
The  "benefactions"  of  our  present-day  civiliza- 
tion, the  crowding  into  large  cities  with  its 
sordid  consequences,  has  forced  us  to  look  upon 
the  use  of  milk  in  its  raw  state  as  a  source  of 
danger,  and  to  eschew  its  use  almost  entirely. 


MILK  103 

The  danger  is  twofold,  as  both  the  alimentary 
canal  and  consequently  the  entire  system  are  at 
once  menaced.  This  is  principally  the  case  with 
small  infants  whose  digestive  organs,  especially 
in  the  summer,  are  so  easily  upset  by  raw  milk, 
which  is  never  sterile.  The  udder  of  the  cow  is 
always  more  or  less  soiled  with  foreign  matter, 
and  this  constitutes  a  first  cause  of  contamina- 
tion, aggravated,  indeed,  by  all  the  manipula- 
tions which  the  milk  undergoes  between  the 
farm  and  the  table  of  the  consumer.  It  is  bad 
enough  in  cold  weather,  but  the  summer  heat 
hastens  the  development  of  bacteria;  fermenta- 
tions arise  at  the  expense  of  the  casein  and  pro- 
duce ptomains.  Thus  charged  with  toxins  and 
microbes,  milk  becomes  the  most  dangerous 
source  of  enteric  trouble,  the  greatest  slayer  of 
infants  known. 

Luckily  much  has  been  achieved  by  dissemi- 
nating this  knowledge  among  the  people  at 
large,  and  the  use  of  boiled  milk  becoming 
more  universal  every  day,  infant  mortality  in 
the  larger  cities  has  been  appreciably  reduced. 

The  infection  which  at  first  attacks  only  the 
digestive  tube,  is  prone  to  spread  and  involve 
the  whole  organism.  Milk  may  become  the 


104  WHAT  SHALL   I    EAT? 

carrier  not  only  of  ordinary  microbes,  but  of 
diphtheria,  typhoid,  scarlatina,  smallpox,  and 
even  tuberculosis.  It  has  been  proved  to  satis- 
faction that  the  bovine  bacillus  may  become 
pathogenic  for  mankind.  It  has  often  enough 
been  discovered  in  milk,  and  despite  the  sani- 
tary measures  of  modern  times,  inspection  of 
stables,  testing  of  cows  with  tuberculin,  con- 
tamination cannot  be  effectually  prevented. 
The  intestines,  no  matter  how  sound,  may  at 
any  time  serve  as  the  gate  of  entrance  to  the 
tubercle  bacillus.  Moreover,  medical  science 
has  not  as  yet  discovered  a  means  by  which 
the  presence  of  this  dreaded  bacillus  can  be 
discovered  in  the  system,  until  it  has  actually 
attacked  an  organ.  All  these  facts  should  as- 
sist in  discouraging  the  use  of  raw  milk  every- 
where. 

Sterilization  of  milk  becomes  therefore  im- 
perative. But  how  to  do  it?  There  are  so 
many  methods,  and  the  results  are  so  unequal. 

Pasteurization,  or  heating  the  milk  at  a  tem- 
perature of  160°  Fahrenheit  for  twenty  or  thirty 
minutes,  is  a  good  method  for  killing  the  princi- 
pal microbes  and  changes  the  milk  but  little. 
But  it  requires  a  special  outfit,  which  is  not  easy 


MILK  105 

to  master  and  handle.  Besides,  the  sterilization 
is  not  complete,  and  milk  cannot  be  protected 
for  any  length  of  time  by  this  process. 

Scalding  the  milk  at  a  temperature  of  210° 
Fahrenheit  for  a  few  minutes  simply  suffices  to 
prevent  the  milk  from  turning,  but  it  will  not 
destroy  all  the  germs.  It  would  not  be  advisa- 
ble to  feed  it  to  a  tender  infant. 

The  best  method  we  can  advocate  is  to  heat 
the  milk  to  210°  Fahrenheit  in  a  steamer  for  at 
least  fifteen  or  twenty  minutes.  This  will  insure 
the  destruction  of  all  pathogenic  germs.  A  few 
yeast  spores  of  casein  remain  behind,  but  that  is 
not  a  matter  of  any  consequence.  But  in  all 
these  methods  it  is  to  be  emphasized  that  the 
milk  must  be  absolutely  fresh. 

With  the  heating  of  milk  up  to  230°  and  240° 
Fahrenheit  for  several  minutes,  we  come  to 
industrial  undertakings.  As  all  the  spores  are 
destroyed,  the  milk  may  be  kept  for  weeks  and 
months.  A  great  many  varieties  of  such  milk 
are  in  the  market.  Some  are  sold  as  in  their 
natural  state,  others  are  modified  so  as  to  ap- 
proach the  composition  of  mother's  milk. 

Recently  some  one  has  been  singing  the 
praises  of  homogenized  milk.  The  object  of 


106  WHAT  SHALL   I    EAT? 

this  preparation  is  to  break  up  the  globules  of 
fat  into  infinitesimally  small  particles,  with  a 
view  to  prevent  the  formation  of  lumps  of  but- 
ter which  are  so  frequently  found  on  the  surface 
of  sterilized  milk. 

We  must,  however,  add  to  this  list,  which  is 
already  overlong,  milk  powder,  a  preparation  of  a 
very  delicate  character,  but  which  seems  to  have 
the  advantage  that  it  keeps  better  and  longer 
than  any  other  variety.  If  its  value  for  infant 
feeding  is  debatable,  it  yet  serves  a  great  purpose, 
especially  for  explorers  and  the  colonial  trade. 

For  nursing  purposes  none  of  the  industrial 
preparations  are  to  be  recommended,  and  we 
can  honestly  say  that  the  farther  milk  is  carried 
from  its  source  of  origin,  the  less  it  will  agree 
with  the  infant,  not  because  of  the  modifications 
of  the  casein,  or  the  elimination  of  the  lecithin 
due  to  the  journey,  but  by  force  of  the  destruc- 
tion of  the  ferments.  This,  perhaps,  will  supply 
an  explanation  why  the  continued  use  of  steril- 
ized milk  has  in  its  train  scurvy  and  Barlow's 
disease. 

Resume.  —  Cow 's  milk  should  not  be  taken  raw. 
Steaming  the  milk  at  home  for  fifteen  or  twenty 
minutes  is  still  the  best  7nethod  of  sterilization . 


MILK  107 

The  commercial  preparations,  harmless  to 
adults,  should  have  added  to  them,  if  at  all 
used  for  infant  feeding,  a  dash  of  orange-juice 
or  that  of  the  lemon. 

It  would  be  futile  to  refer  to  the  endless  uses 
to  which  milk  is  put  in  the  culinary  art.  Most 
of  them  are  beyond  criticism,  some  are  perhaps 
a  little  hard  to  digest.  If  you  suffer  from  ar- 
thritis, do  not  forget  that  the  addition  of  a  bit 
of  milk  singularly  increases  the  nutritive  power 
of  certain  dishes. 

ADULTERATIONS 

For  the  comfort  of  readers  residing  in  New 
York  City  the  translator  subjoins  here,  without 
guaranty,  however,  for  its  correctness,  an  article 
which  appeared  in  the  New  York  Times  on  July 
25,  1910,  under  the  heading  of  ''Topics  of  the 
Times:" 

MILK   IS   HIGH,   BUT   CLEAN 

However  badly  9  and  10  cent  milk  may  choke  New 
York  at  thought  of  the  price,  there  ought  to  be  some 
consolation  in  the  assurance  that  at  least  it  is  the  purest 
and  cleanest  milk  in  the  world.  That  it  is  clean  and 
pure  may,  indeed,  explain  in  part,  though  by  no  means 


108  WHAT  SHALL   I    EAT? 

altogether,  its  high  price.  And,  while  the  milk  purvey- 
ors as  a  rule  have  cooperated  cheerfully  with  the  health 
authorities  in  maintaining  a  high  standard  of  milk-sup- 
ply, the  untiring  work  of  the  Health  Department  is  at 
the  bottom  of  the  inestimable  result. 

Dr.  Darlington,  when  Health  Commissioner,  labored 
diligently  to  keep  the  milk  sold  here  uncontaminated,  a 
task  not  easy  in  a  territory  covering  half  a  dozen  States, 
extending  north  into  Massachusetts  and  west  into  Ohio. 
Commissioner  Lederle,  as  shown  by  a  recent  statement  of 
his  methods  of  dairy  inspection,  has  not  permitted  the 
work  to  lag  a  moment.  Not  only  are  samples  of  practi- 
cally all  the  milk  brought  into  the  city  analyzed  daily  in 
the  Health  Department  laboratories,  but  a  keen  lookout 
is  kept  over  the  entire  city  for  sectional  outbreaks  of 
disease  which  may  be  traceable  to  the  milk-supply.  Dr. 
Lederle's  statement  shows  also  that  the  closest  practicable 
reckoning  is  kept  of  the  thousands  of  dairies  which  sup- 
ply the  city.  This  inspection  is  maintained  by  a  corps 
of  trained  men  who  visit  the  dairies  at  regular  and  often 
at  irregular  intervals.  For  each  dairy  a  score  card  is 
kept  by  the  inspector  for  the  Health  Department,  and 
each  dairy  has  its  rating.  It  is  80,  90,  or  95  per  cent 
good,  as  the  condition  found  by  the  inspector  warrant. 
If  it  falls  below  the  high  standard  required  its  milk  can- 
not come  into  New  York  until  all  objectionable  conditions 
are  removed.  The  fact  is,  the  requirements  on  the  dairies 
are  more  exacting  in  cleanliness  of  cows  and  milkers  than 
are  usually  maintained  for  private  consumption  anywhere 
in  this  country.  The  Attorney-General,  who  has  inves- 
tigated this  question,  says  that  the  charges  for  milk  are 
exorbitant.  But  it's  clean  and  rich,  and  it  is  far  better 


MILK  109 

for  the  people  that  it  is  such  than  if  it  were  not  clean, 
not  pure,  mixed  with  water,  and  possibly  dirty  water  at 
that,  and  yet  cheap. 

A  few  words  here  about  cryoscopic  analysis, 
which  seems  to  render  an  excellent  means  for 
controlling  and  testing  the  purity  of  milk. 

Pure  milk  freezes  at  31  °  Fahrenheit.  This  is 
a  fixed  figure,  no  matter  what  the  proportion  of 
the  different  constituents  may  be  or  the  age  of 
the  cow  or  the  fodder  given.  Every  deviation 
shown  by  the  cryoscopic  thermometer  points  to 
some  adulteration.  This  process  of  inspection, 
which  requires  a  little  time,  and  a  small  outlay 
for  instruments,  deserves  the  careful  attention 
of  every  large  community,  inasmuch  as  it  is  of 
the  utmost  importance. 

REACTIONS 

a.  Digestive. — Of  all  the  foodstuffs,  milk  is 
the  one  which  makes  the  least  demand  on  the 
digestive  glands,  and  causes  them  the  smallest 
amount  of  excitation.  Clinical  facts  and  lab- 
oratory research  agree  on  this  point.  Pauloff, 
above  all  others,  has  made  a  special  study  of 
the  reaction  of  milk  on  the  digestive  secretions. 
In  the  stomach,  with  an  equal  amount  of  albu- 


110  WHAT  SHALL  I   EAT? 

min,  milk  produces  a  chlorhydropeptic  secre- 
tion, inferior  to  that  of  meat  and  much  inferior 
to  that  of  bread.  In  the  duodenum,  with  the 
same  quantity  of  fat,  the  secretion  of  steapsin  is 
scantier  than  with  meat;  with  the  same  quan- 
tity of  carbohydrates  the  amylolytic  secretion  is 
slightly  lower  than  with  bread. 

The  study  of  the  nitrogenous  changes  gave 
this  same  author  the  chance  to  observe  at  what 
little  expense  the  digestive  process  of  milk  is 
carried  on.  A  meal  of  bread  produced  in  a 
dog,  during  the  subsequent  hours,  an  enormous 
rise  in  urinary  nitrogen;  with  a  feed  of  milk, 
containing  the  same  amount  of  nitrogen,  the 
rise  observed  was  nearly  three  times  less.  The 
ingestion  of  nitrogen  being  the  same  in  both  in- 
stances, the  difference  in  the  rise  can  only  be 
ascribed  to  the  difference  of  the  digestive  labor, 
considerable  in  the  first  instance,  a  minimum  in 
the  second.  Moreover,  the  milk  was  retained, 
and  in  a  fashion  had  an  equally  beneficial  effect 
on  the  intestinal  flora  and  on  the  ferments  which 
it  provoked,  thus  proving  its  antiseptic  and  an- 
titoxic qualities.  But  we  must  make  here  a 
necessary  restriction  in  order  to  explain  the 
complexity  of  the  clinical  facts.  This  beneficial 


MILK  111 

influence  cannot  be  exercised  unless  the  diges- 
tive functions  are  normal  and  the  milk  is  well 
digested.  Under  such  conditions  a  milk  diet 
should  make  the  intestinal  flora  fall  from  67, 000 
to  2,500  c. mm.  —  (Gilbert  and  Diminici.)  The 
change  from  a  meat  diet  to  a  milk  diet  is  ac- 
companied by  an  important  diminution  of  uri- 
nary sulphoether.  Rapid  digestion  of  casein, 
antiseptic  action  of  lactic  and  succinic  acids, 
which  are  derived  from  the  lactose,  such  is  the 
double  explanation  of  this  phenomenon. 

If,  e  contra,  the  milk  is  badly  digested,  if  the 
intestines  are  already  infected,  the  casein  be- 
comes the  prey  of  proteolytic  bacilli,  and  ad- 
vances their  growth  and  ferments  by  giving 
way  to  powerful  toxins.  This  explains  the  fact 
that  in  numerous  cases  of  enteric  trouble,  the 
ingestion  of  milk  is  accompanied  by  aggravated 
symptoms,  which,  however,  disappear  with  the 
removal  of  the  cause. 

b.  General.  — The  influence  of  a  milk  diet  on 
the  general  system  is  of  the  same  nature.  The 
absence  of  stimulation  is  the  principal  character- 
istic Hence  the  feeling  of  faintness  so  often 
experienced  by  those  who  by  sickness  are  re- 
duced to  a  milk  diet.  They  do  not  suffer  from 


112  WHAT  SHALL   I    EAT? 

the  want  of  calories,  but  from  the  want  of  an 
excitant. 

All  the  organs  are  benefited  by  the  quieting 
action  of  milk:  the  nervous  system,  the  liver,  and 
probably  also  all  the  glands  of  the  blood-vessels. 

In  a  like  manner  it  affects  the  heart  and  the 
vascular  system.  Milk  is  a  sedative  of  the 
first  order.  Its  poverty  in  salt,  the  absence  of 
xanthic  substances,  the  characteristics  of  its  own 
albumin  (one  of  the  least  toxic),  all  aid  in  this 
action. 

It  suppresses  the  toxins  in  the  circulation, 
neutralizes  vascular  construction  and  defective 
tension  (the  natural  consequence  of  the  former), 
and  relieves  the  action  of  the  heart.  The  ease 
with  which  it  is  digested  is  favorable  to  the 
cardiac  functions;  every  act  of  digestion  must 
fatigue  the  heart.  With  milk  this  fatigue  is 
reduced  to  a  minimum. 

3d.  Eliminating.  — Neither  is  the  influence  on 
the  kidneys  less  profound  or  favorable.  Anti- 
toxic, rich  in  lactose,  poor  in  salt,  milk  is  an  ad- 
mirable diuretic.  It  is,  indeed,  a  common  case  of 
Bright' s  oliguria,  in  which  a  milk  diet  is  able  to 
increase  the  daily  output  of  urine  to  3  or  4  liters. 

Sedative   and   antiseptic   for    the   alimentary 


MILK  113 

canal,  antitoxic  and  calming  for  the  general 
system,  diuretic  for  the  renal  glands,  milk  lays 
claim  to  the  title  of  a  therapeutic  agent  of  the 
first  order.  But  these  properties  will  not  be  re- 
alized unless  milk  is  used  when  and  where  it  is 
needed.  The  absolute  milk  diet  requires  certain 
precautions  to  which  we  shall  give  forthwith 
proper  attention. 

ABSOLUTE    MILK   DIET 

The  physician  should  not  content  himself 
with  simply  prescribing  a  milk  diet  to  his  pa- 
tient, but  he  must  complement  his  orders  with  a 
series  of  instructions  without  which  good  and 
satisfactory  results  cannot  be  obtained.  Their 
object  must  be  to  correct  the  faulty  distribution 
of  the  alimentary  principles  in  the  milk  and  to 
insure  proper  digestion. 

1st.   In  the  adult  the  ideal  proportions  would 

be: 

Albumin 18.1 

Fat 10.4 

Carbohydrates 71.5 

But  the  actual  proportions  in  the  milk  are: 

Albumin 28.0 

Fat 30.0 

Carbohydrates 42.0 


114  WHAT  SHALL   I    EAT? 

Fat,  therefore,  is  too  predominant  and  carbo- 
hydrates are  wanting. 

The  former  may  be  remedied  by  boiling  or 
skimming  the  milk,  especially  in  liver  troubles. 
The  latter  may  be  improved  by  the  addition  of 
either  ordinary  sugar  or  of  lactose,  according  to 
the  amount  of  diuresis  which  it  is  intended  to 
produce. 

It  is  also  advisable  to  take  with  the  milk  a 
few  dry  biscuits  (crackers)  in  almost  all  cases 
of  illness.  This  is  of  practical  value,  as  it  gives 
strength  to  the  patient  and  reduces  the  quantity 
of  liquid  to  be  taken. 

It  requires  3  liters  of  pure  milk  to  make  a 
proper  ration. 

670  X  3  =  2,010  calories 

If  50  grams  of  sugar  (ten  lumps)  per  liter  and 
80  grams  of  dry  biscuit  (crackers)  are  added,  2 
liters  of  milk  will  be  sufficient. 

670  X  2  +  400  X  0.80  +  397  =  2,057  calories 

These  proportions  are  more  ideal  and  the  ra- 
tion is  superior.  The  addition  of  thick  barley- 
water  or  of  gruel,  in  quantities  to  be  regulated 
by  the  nature  of  the  disease,  will  often  prove 
beneficial. 


MILK  115 

2d.  It  will  happen  often  enough  that  the 
milk  is  not  well  tolerated  by  the  patient,  pro- 
ducing gastric  fermentations,  or  diarrhea  or 
constipation.  This  may  be  the  fault  of  the  doc- 
tor, who  has  not  taken  all  the  circumstances  of 
the  case  into  proper  consideration.  The  tem- 
perature of  the  milk  is  an  important  factor. 
When  once  boiled,  the  milk  may  be  taken  either 
hot,  lukewarm,  or  cold,  just  as  the  patient  pre- 
fers it.  We  should  never  forget  that  the  fashion 
in  which  milk  is  preferred  by  the  patient  has  a 
strong  influence  on  its  digestibility. 

To  aid  digestion,  milk  should  be  taken  slowly 
and  in  small  quantities.  Without  this  precau- 
tion it  is  apt  to  form  large  floccules  and  to  fer- 
ment. There  should  be  an  interval  between 
each  dose.  Two  liters  of  milk  should  make  six 
to  seven  doses.  If  to  be  taken  in  six  doses,  then 
350  grams  should  be  administered  every  three 
hours;  if  in  seven  doses,  then  300  grams  should 
be  given  every  two  hours,  thus  leaving  seven 
hours  for  a  night's  rest.  Each  dose  should  be 
fed  slowly,  with  a  spoon,  for  a  quarter  of  an 
hour.  The  milk  should  be  eaten,  not  drunk. 
It  should  be  masticated,  chewed,  in  order  to  mix 
it  with  the  salivary  secretions  so  necessary  for 


116  WHAT  SHALL   I    EAT? 

the  digestion  of  lactose.  This  is  facilitated  by 
soaking  crackers,  or  bits  of  bread  in  the  milk. 

3d.  The  disgust  or  nausea,  so  easily  gener- 
ated by  this  insipid  and  monotonous  mess,  is 
another  impediment  to  good  digestion,  and  pre- 
vents proper  assimilation.  The  doctor  would  do 
wrong  if  he  were  to  be  relentless,  or  relied  too 
much  on  the  energy  of  the  patient  or  the  insist- 
ence of  the  attendants.  He  will  gain  more  by 
allowing  a  few  cups  to  be  seasoned  with  a  few 
drops  of  tea,  or  coffee,  or  even  brandy,  if  the 
condition  of  the  patient  permits,  or  to  flavor  the 
milk  with  a  trifle  of  vanilla,  or  caramel,  or 
orange-blossom,  etc. 

4th.  The  greatest  obstacle,  however,  to  a  suc- 
cessful milk  diet  is  gastric  hyperacidity,  which 
quickly  coagulates  the  casein  into  compact  clots 
and  large  masses,  leaving  little,  if  anything,  for 
digestion.  The  addition  of  Vichy  or  soda  water 
(potash  water  is  preferable)  will  act  as  a  correc- 
tive. Bicarbonate  of  soda  (baking-powder)  and 
lime-water  also  will  modify  this  acid  propensity. 
Rennet,  the  virtues  of  which  have  in  recent 
years  been  so  much  extolled,  should,  we  think, 
not  be  used. 

5th.  As  a  last  precaution  we  recommend,  es- 


MILK  117 

pecially  in  cases  of  infection  and  cachexia,  that 
the  mouth  and  the  gums  be  carefully  rinsed 
with  a  draught  of  Vichy  or  soda  water.  This  is 
the  only  effective  way  in  which  the  remaining 
particles  of  milk  that  provoke  lactic  ^fermenta- 
tion and  so  readily  cause  the  appearance  of 
thrush,  can  be  effectively  removed. 

For  severe,  acute  attacks  of  cold  in  the  head, 
or  of  grippe  or  influenza  in  the  incipient  stages, 
the  following  recipe  will  prove  of  decided  advan- 
tage and  comfort: 

Half  a  pint  of  boiling  milk, 

One  or  two  lumps  of  sugar, 

One  tablespoonful  of  dry  gin  (London  gin). 

Stir  thoroughly  and  pump  into  it  two  or  three  gen- 
erous dashes  of  soda  or  potash  water  from  a  syphon. 
Drink  hot  after  going  to  bed.  Cover  up  well.  A  co- 
pious perspiration  will  ensue,  with  a  subsequent  feeling 
of  relief  and  extreme  comfort. — {Translator.) 

INDICATIONS   AND   CONTRAINDICATIONS 

Milk  as  a  Food  for  Infants. — We  can  only 
succinctly  repeat  here  the  principal  rules  which 
govern  the  nursing  of  babies;  referring  the 
reader  for  details  to  the  larger  text-books. 

Nothing,  so  far  as  infant  feeding  is  concerned, 
can  excel  mother's  milk  or  replace  the  breast. 


118  WHAT  SHALL   I    EAT? 

We  have  already  on  a  previous  page  given  the 
reasons  for  this  statement.  The  average  length 
of  time  for  suckling  is  from  twelve  to  fourteen 
months.  Marfan  fixes  ten  to  eighteen  months 
as  the  minimum  and  maximum  period  for 
weaning. 

Mixed  nursing,  in  which  the  breast  is  alter- 
nated with  the  bottle,  is  not  an  equivalent  to 
suckling,  although  it  has  certain  advantages. 
The  small  quantity  of  mother's  milk  absorbed 
by  the  baby  provides  the  necessary  ferments. 
Should  the  bottle  disagree  with  the  child,  it  is 
easy  to  give  it  the  breast  alone  for  a  few  days. 
If  the  mother  has  not  milk  enough,  or  if  suck- 
ling fatigues  her  too  much,  mixed  nursing  must 
of  necessity  be  resorted  to. 

In  some  places  the  babies  are  put  to  the 
nipple  of  the  goat;  although  the  method  is 
superior  to  bottle-feeding,  it  cannot  often  be 
obtained. 

To  raise  a  baby  on  cow's  milk  alone  is  a  diffi- 
cult task,  especially  in  large  cities,  and  requires 
many  precautions.  The  milk  must  always  be 
boiled,  and  at  first  must  be  diluted  with  water 
and  sweetened  with  sugar,  or  a  spoonful  of  milk- 
sugar.  The  quantity  of  water  must  be  grad- 


MILK  119 

ually  lessened,  and  about  the  eighth  month  pure 
milk  may  be  given. 

About  this  time  one  may  begin  to  give  pap, 
of  which  we  shall  speak  a  little  later  on.  But 
for  a  long  time  milk,  which  is  such  excellent 
nutriment  for  growth,  must  take  the  foremost 
place  in  the  feeding  of  the  child. 

Pyrexia. — Nourishing,  easy  to  digest,  allevi- 
ating the  heart  and  kidneys,  milk  presents  a 
good  article  of  food  for  all  acute  diseases,  and 
forms  the  most  convenient  base  for  a  fever  diet. 
Skimmed  milk  is  very  useful  in  such  cases,  as  it 
does  not  burden  the  stomach  for  any  length  of 
time,  being  digested  rapidly.  When  sweetened 
with  milk-sugar  it  proves  beneficial  in  oliguria, 
mixed  with  brandy  in  adynamia,  and  with  bar- 
ley-water and  gruel  in  cases  of  intense  denu- 
trition. 

Gastrointestinal  Affections. — The  time  is  not 
far  off  when  milk  will  be  the  foremost  remedy 
for  dyspepsia;  although  it  does  not  suit  every 
case,  because  its  sedative  reaction  and  propensity 
to  cause  fermentation  proves  at  times  objection- 
able. 

In  all  gastric  defects  of  a  serious  nature,  espe- 
cially in  cancer,  in  all  forms  of  severe  excitation, 


120  WHAT  SHALL   I    EAT? 

such  as  ulcers  and  hyperchlorhydria,  milk  is  of 
great  utility.  In  the  latter  case  particularly, 
the  absolute  milk  diet  should  always  be  advised, 
as  it  produces  marvelous  cures. 

Milk  must  be  prohibited  in  gastrointestinal 
atonia,  in  severe  dilatation  of  the  stomach,  in 
gastritis  and  in  gastroenteritis,  in  cancer  with 
processus  inflammatorius,  and  in  certain  nervous 
affections  (nervous  vomiting,  rumination). 

For  the  rest  of  the  cases  a  moderate  use  is 
not  injurious;  but  it  should  only  be  taken 
with  soup  or  mixed  with  other  eatables.  Under 
no  consideration,  however,  should  milk  be  used 
as  a  beverage  during  the  repast,  because  in 
this  form  it  retards  the  process  of  digestion 
and  favors  fermentation.  Taken  by  itself,  milk 
is  an  antiseptic;  but  when  used  as  a  drink 
with  other  foods,  it  becomes  an  autotoxin.— 
(Pascault ) 

In  intestinal  therapeutics  much  reserve  must 
be  employed  in  the  use  of  milk,  for  whatsoever 
answers  no  good  purpose  easily  entails  injury. 
Its  quick  binding  and  absorbing  qualities  make 
it  react,  as  a  rule,  favorably  in  attacks  of  diar- 
rhea, markedly  so  in  cases  of  chronic  diarrhea  in 
hot  climates.  Nevertheless,  meat- juice,  and  even 


MILK 

raw  meat,  may  here  prove  more  beneficial.  In 
enteric  fever  in  adults,  its  action  is  unreliable, 
being  well  tolerated  by  some  individuals,  but 
producing  fermentation  and  flatulence  in  others. 
Combe,1  of  Lausanne,  strenuously  opposes  the 
use  of  milk  in  any  kind  of  intestinal  inflamma- 
tion. In  infants  of  tender  age,  enteritis  consti- 
tutes an  absolute  contraindication. 

It  is  often  quite  sufficient  to  promptly  stop 
the  use  of  milk  in  order  to  bring  about  immedi- 
ate improvement.  Extreme  caution  must  be 
exercised  in  resuming  the  milk  diet.  It  should 
be  accomplished  in  easy  stages  and  with  small 
doses. 

To  the  constipated,  those  great  eaters  with 
chronic  cecal  obstruction,  the  use  of  milk  will 
not  readily  appeal.  In  enterocolitis,  it  should 
constitute  a  part  of  the  regimen,  but  in  small 
allowances  only. 

Affections  of  the  Liver. — At  the  last  Congress 
of  Food  and  Hygiene  the  indications  were  elo- 
quently described  by  A.  Robin.  He  empha- 
sized the  fact  that  while  milk  in  many  cases  is 
most  useful,  by  force  of  its  sedative  and  quiet- 

'Combe:  "Intestinal  Autointoxication,"  English  translation 
by  G.  W.  States,  Rebman  Company,  New  York. 


122  WHAT   SHALL   I    EAT? 

ing  effects  on  the  liver,  yet  the  lack  of  stimu- 
lating power  may  also  render  it  harmful. 

The  milk  diet  gives  relief  in  cancer,  in  the 
first  stages  of  cirrhosis,  biliary  hypertrophic  cir- 
rhosis, Laennec's  cirrhosis  in  its  first  stage,  hepa- 
titis indigenous  in  hot  climates,  and  in  arthritic 
enlargement  of  the  liver.  In  the  second  stage 
of  cirrhosis  a  milk  diet  is  too  excitant.  In  icte- 
rus the  use  of  milk  must  be  stopped  as  soon  as 
the  primary  crisis  has  come  to  an  end. 

In  lithiasis  Gilbert  recommends  skimmed  milk 
in  small  doses  in  order  to  stop  migration  of  the 
calculi;  but  after  that  crisis  has  passed,  milk 
must  be  stopped. 

Affections  of  the  Heart  and  the  Blood-  Vessels. 
—Every  asystolic  condition  invites  an  absolute 
milk  diet.  Huchard  has  shown  its  beneficent 
action  in  cardiopathic  conditions  of  the  arteries, 
in  supertension,  in  arteriosclerosis,  whether  it 
consists  of  functional  disorders  or  fixed  lesions. 
Although  these  diseases  do  not  radically  yield 
to  a  milk  diet,  yet  these  cures,  undertaken  for  a 
few  days  in  each  month,  wash  out  the  tissues 
and  bring  about  a  toxic  correction  which  can 
only  benefit  the  general  conditions  of  health. 

Nephritis. — As  for  the  heart  so  for  the  kid- 


MILK  123 

neys,  milk  is  an  heroic  food,  being  at  the  same 
time  antitoxic,  hypotensive,  and  diuretic.  The 
researches  made  recently  by  Widal  and  Javal 
have  brought  much  light  into  this  question. 
According  to  these  authors,  milk  acts  like  an 
agent  charged  with  hypochlorite,  easing  the  kid- 
ney that  has  become  impermeable  to  chlorids. 
And  as  it  is  not  difficult  to  find  other  foods  even 
less  chlorated  than  milk  (farinaceous  foods, 
pastes,  unsalted  bread,  and  even  meat)  these 
may  advantageously  be  employed  to  replace  the 
former  in  the  diet  list  for  Bright' s  disease. 
These  conclusions  are  of  more  than  passing  in- 
terest, as  it  often  becomes  necessary  to  change 
the  diet  of  the  patient.  Nevertheless,  they 
should  not  let  us  lose  sight  of  the  special  quali- 
ties of  the  lactose  and  albumin  contained  in  the 
milk.  In  acute  nephritis  and  in  slight  and 
severe  attacks  of  uremia  the  milk  diet  should 
be  rigidly  enforced,  special  precautions  being 
adopted  that  it  is  well  tolerated.  In  all  cases  of 
dropsy,  milk  is  an  important  factor  in  the  diet 
list. 

Nervous  Affections. — Calming,  antitoxic,  rich 
in  phosphorus,  milk  is  in  all  these  affections  an 
excellent  nutrient,  the  more  strongly  indicated 


124  WHAT  SHALL   I    EAT? 

the  higher  the  nervous  tension.  According  to 
Weir  Mitchell  it  is  the  only  food  permissible  in 
the  treatment  of  neurasthenia. 

Cancer.  Tuberculosis. — Milk  is  by  far  the 
finest  food  for  building  and  feeding  up  the  con- 
stitution. Its  use  is  preeminently  indicated  in 
all  stages  of  denutrition,  of  which  these  two  dis- 
eases are  prototypes.  Many  consumptives  are 
able  to  consume  several  cups  of  milk  between 
meals.  Of  course,  this  form  of  superalimenta- 
tion  is  not  required  in  patients  who  are  blessed 
with  a  strong  digestive  apparatus. 

Arthritis. — The  employment  of  milk  in  ar- 
thritis is  one  of  those  delicate  questions  which 
cannot  be  answered  with  absolute^certainty.  In 
some  cases  it  is  to  be  shunned,  primarily  as  a 
means  of  excessive  nourishment  which  adds  too 
much  force  to  a  diet  already  too  abundant,  and 
the  danger  always  exists  that  on  account  of  the 
good  reputation  it  enjoys,  the  patient  is  apt  to 
use  it  too  generously.  Besides,  many  persons 
suffering  from  arthritis  are  troubled  with  an 
atonic  and  sluggish  alimentary  apparatus  which 
is  incapable  of  digesting  milk,  thus  inviting 
stasis,  fermentation,  and  intestinal  congestion. 
Yet  there  are  patients  who  respond  well  to  a 


MILK  125 

generous  milk  diet  enforced  during  several  days. 
But  it  must  be  preceded  by  a  thorough  purging. 

It  is  always  wise  to  keep  an  account  of  the 
various  clinical  facts,  viz.,  beware  of  cecal  sta- 
sis and  of  intestinal  fermentation;  bear  in  mind 
that  milk,  wrongfully  employed  or  badly  digest- 
ed, may  become  the  source  of  serious  untoward 
events. 

In  gout  and  lithemia  everything  can  be 
gained  by  a  diet  absolutely  free  from  all  puric 
substances,  but  it  is  proverbially  true  that  the 
arthritics  form  a  family  that  disregards  all  re- 
strictions as  to  diet  with  the  utmost  audacity. 

In  oocaluria  milk  must  be  neglected  on  ac- 
count of  its  richness  in  lime  and  its  poverty  in 
magnesium.  —  (Klemperer. ) 

Diabetes.  — The  natural  tendency,  of  course,  is 
to  interdict  the  use  of  milk  because  it  is  too  rich 
in  lactose,  yet  sugar  of  milk  is  better  tolerated 
on  an  average  than  other  forms  of  carbohy- 
drates, and  there  are  cases  on  record  in  which 
a  milk  diet  lowered  the  percentage  of  sugar 
appreciably.  Although  we  should  consider  it 
wrong  to  particularly  recommend  a  milk  diet  to 
diabetic  persons,  still  it  is  sometimes  advisable 
to  fall  back  upon  it.  The  susceptibility  of  the 


126  WHAT  SHALL   I    EAT? 

patient  should  first  be  tested,  and  in  the  face  of 
the  many  complications  that  usually  accompany 
this  disease,  it  is,  perhaps,  just  as  well  not  to  re- 
linquish at  once  this  ever-valuable  aid. 

DERIVATIVES   OF   MILK 

Casein  and  butter  are  the  nutritive  constitu- 
ents of  milk,  while  lactose,  lactic  acid,  and  the 
salts  may  be  looked  upon  as  valuable  remedies. 
The  therapeutic  value  of  all  the  derivatives  of 
which  we  intend  to  speak  here  depend  upon  the 
latter  qualities. 

I.     BUTTER-MILK 

Albumin.  Fat.  Carbohydrates.  Ash.         Available  Calories. 

2.6  0.6  3.2  0.74  29 

It  consists  of  what  is  left  of  the  milk  after  the 
butter  has  been  churned  out  of  it.  This  residue 
has  been  robbed  of  its  fat  and  a  small  portion 
of  casein;  but  lactose  remains,  with  the  excep- 
tion of  a  minor  amount  which  has  undergone 
lactic  fermentation. 

This  modification  renders  it  an  excellent  rem- 
edy for  gastrointestinal  troubles  in  infants;  the 
absence  of  fat  makes  it  easier  to  digest,  and  ex- 


MILK  127 

ercises  a  direct  disinfectant  action  on  intestinal 
putrefaction. 

In  acute  gastroenteritis  it  may  be  found  more 
or  less  superior  to  soups  made  of  legumes.  Ac- 
cording to  Rivet,  buttermilk  affects  the  feces  in 
the  same  manner  as  nursing  at  the  breast  does. 
It  is  also  highly  spoken  of  in  cases  of  infantile 
eczema.  —  (Lesne. ) 

If  80  or  90  grams  of  sugar  per  liter,  or  a 
tablespoonful  of  flour  be  added  and  the  whole 
cooked  just  to  the  boiling-point  over  a  slow  fire, 
it  will  make  a  food  almost  as  nourishing  as  pure 
milk. 

II.    WHEY 

True  whey  is  the  liquid  left  after  the  milk 
has  been  coagulated  by  the  aid  of  rennet,  and  is 
nothing  but  the  clear  opalescent  serum  of  cur- 
dled milk.  This  is  the  sweet  whey  as  against  the 
add  or  cheesy  whey  obtained  by  the  addition  of 
tartaric  acid.  It  contains  less  albumin,  hardly 
any  fats,  but  the  whole  of  the  lactose,  a  portion 
of  which  is  transformed  into  lactic  acid,  and  all 
the  salts  of  milk,  with  the  exception  of  phos- 
phate of  lime,  which  is  eliminated  with  the 
casein. 


128  WHAT  SHALL   I    EAT? 

This  liquid  contains  but  little  nourishment, 
but  possesses  highly  diuretic  and  mineralizing 
qualities.  It  is  also  slightly  laxative. 

Whey -cures  are  frequently  taken  in  Germany 
for  the  purpose  of  flushing  toxic  bodies  out  of 
the  organism  in  gout,  stone,  liver  complaints, 
and  gastrointestinal  troubles. 

The  proper  amount  to  be  taken  should  not 
exceed  500  to  750  c.c.,  in  doses  of  150  c.c.  at 
regular  intervals  in  the  morning  and  afternoon. 

III.     KEPHIR 

Lactic  Available 

Albumin.1       Fats.          Lactose.          Acid.         Alcohol.  Ash.          Calories. 

2.9         3.1         2.9         0.6         0.6         0.65         55 

It  is  obtained  by  a  process  of  alcoholic  and 
lactic  fermentation  of  cow's  milk,  or  sheep's 
milk,  by  the  aid  of  two  fermenting  agents,  i.  e. , 
the  saccharomyces  mycoderma  and  the  dipsora 
caucasia.  Kephir  comes  from  the  Caucasian 
mountains.  Kephir  tablets  are  a  commercial 
article,  and  can  be  used  in  any  household,  al- 
though it  is  rather  difficult  to  obtain  satisfactory 
results  with  them  at  home.  Here  is  the  recipe. 
Boil  the  milk,  take  off  the  cream;  fill  the  bottle 
three-quarters,  add  the  kephir  tablet,  cork  the 
1  These  figures  refer  to  fatty  kephir  two  days  old. 


MILK  129 

bottle  tight,  and  put  it  in  a  warm  place.  It 
should  be  shaken  every  two  hours.  The  amount 
of  alcohol  and  of  lactic  acid  is  increased  by  pro- 
tracted fermentation.  As  a  rule,  kephir  No.  2 
is  employed,  which  has  fermented  for  two  days. 
Kephir  of  one  day's  standing  is  rather  laxative, 
and  that  of  three  days'  very  constipating. 

Its  characteristic  properties  are:  1,  peptoniza- 
tion  of  a  small  amount  of  casein;  2,  presence  of 
lactic  acid,  which  acts  as  an  intestinal  antisep- 
tic; 3,  presence  of  alcohol  and  carbonic  acid 
formed  from  the  lactose  and  acting  as  stimulants 
to  the  process  of  digestion;  4,  an  abundance  of 
diastase  partly  derived  from  the  yeasts. 

Reactions  of  Kephir. — a.  On  the  stomach.  It 
is  a  food  easily  digested,  as  it  does  not  remain  in 
the  stomach  very  long,  especially  so  if  it  is  made 
of  skimmed  milk.  Experiments  made  by  Gil- 
bert and  Chassevant  show  the  following  results: 

One  liter  of  raw  milk  remains  in  the  stomach  for  seven 
hours. 

One  liter  of  skimmed  and  boiled  milk  remains  in  the 
stomach  for  five  hours. 

One  liter  of  fatty  kephir  No.  2  remains  in  the  stomach 
for  four  and  one-half  hours. 

One  liter  of  kephir,  made  from  skimmed  milk,  No.  2, 
remains  in  the  stomach  for  three  and  one-half  hours. 


130  WHAT  SHALL   I    EAT? 

b.  It  accelerates  nutrition,  by  raising  the  rate 
of  urea  and  diminishing  the  acidity  and  the 
amount  of  uric  acid.  It  is  also  likely  that  it 
aids  assimilation,  as  a  number  of  authorities 
have  observed  that  kephir  makes  flesh  more 
rapidly  than  any  other  food. 

We  specially  recommend  it: 

For  a  number  of  gastric  and  intestinal  trou- 
bles; for  hypopepsia,  chronic  gastritis,  and  apep- 
sia  (here  it  will  greatly  aid  digestion);  it  will 
often  stop  vomiting  in  pregnancy;  in  cases  of 
cancer  it  often  affords  great  relief. — (Martinet) 
In  chronic  enteritis  and  in  dysentery  it  is  a  strong 
factor  in  intestinal  assimilation.  (On  account  of 
its  richness  in  acids  and  alcohol  it  is  harmful  in 
cases  of  hyperchlorhydria  and  ulcers. ) 

For  consumptives,  emaciated,  anemic,  and  ner- 
vous persons,  in  whom  the  daily  losses  are  not 
compensated  by  proper  assimilation. 

A  special  point  in  favor  of  kephir  as  a  food 
for  phthisical  patients  is  its  action  on  the  stom- 
ach, on  the  canal,  and  on  nutrition  in  general, 
which  is  clearly  antagonistic  to  the  actions  of  the 
tubercle  poisons.  It  renders  also  great  services 
in  stimulating  a  failing  appetite  and  arresting 
a  stubborn  loss  of  flesh.  Certain  invalids  never 


MILK  131 

begin  to  pick  up  till  they  are  put  on  a  diet  of 
kephir. 

It  is  not  to  be  recommended  in  affections  of 
the  heart,  or  the  kidneys,  or  the  blood-vessels; 
not  to  patients  who  have  a  leaning  to  plethora 
or  congestion. 

The  usual  dose  is  from  half  a  liter  to  a  liter 
at  noon  for  luncheon,  or  about  four  o'clock  for 
a  repast.  Patients  who  are  on  a  strict  kephir 
diet  should  follow  the  same  regimen  as  those  on 
a  strict  milk  diet,  although  the  doses  may  be 
slightly  increased  because  the  nutritive  coeffi- 
cient is  smaller. 

IV.     KOUMYS 

Lactic  Available 

Albumin.          Fats.  Lactose.          Acid.  Alcohol.  Ash.       Calories. 

2.20       2.12        1.53        0.90        1.72        0.29        44 

Koumys,  formerly  prepared  only  by  the  Tar- 
tars, has  gradually  found  its  way  westward.  It 
is  made  of  mare's  milk  with  a  process  of  lacto- 
alcoholic  fermentation,  similar  to  that  of  kephir, 
though  stronger.  The  technique  is  pretty  well 
the  same,  but  the  germ  used  differs.  The  milk 
is  put  into  bottles  five  hours  after  fermentation 
has  set  in,  which  is  then  allowed  to  continue 


WHAT  SHALL   I    EAT? 

for  five  to  six  days.  The  product  is  an  "emul- 
sified liquid,  effervescent,  with  a  sweetish,  acid- 
ulated taste,  reminding  the  palate  of  the  taste 
of  milk  of  almonds.  It  stimulates  the  appetite, 
aids  digestion,  and  is  slightly  intoxicating. ' ' 
(Gautier. ) 

It  differs  from  kephir  by  a  stronger  percent- 
age of  alcohol  and  peptones,  and  a  smaller 
percentage  of  salts.  Indications  and  contrain- 
dications are  for  both  the  same,  except  that 
koumys  should  be  taken  in  smaller  doses. 

V.    YOGHOURT 

Curdled  milk  has  been  employed  during  all 
ages  and  the  whole  world  over,  although  it  is 
known  under  different  names  in  different  re- 
gions. The  curdled  milk  of  Bulgaria  or  Yog- 
hourt  contains  only  two  lactic  ferments,  i.e.,  a 
streptococcus  bacillus  and  a  streptobacillus  called 
Maya.  However,  what  we  are  about  to  say  of 
the  curdled  milk  of  Bulgaria  refers  just  as  well 
to  any  other  ordinary  curdled  milk. 

To  make  yoghourt  the  milk  should  be  boiled 
down  to  three -fourths  of  its  quantity;  it  should 
then  be  cooled  off  to  112°;  the  Maya  ferment  is 
then  added,  and  the  vessel  containing  the  milk 


MILK  133 

is  kept  in  a  temperature  of  112°  for  six  to  eight 
hours,  when  the  milk  is  curdled. 

The  characteristic  qualities  of  yoghourt  are 
the  presence  of  lactic  acid,  varying  from  10  to 
20  grains  per  liter,  and  the  solubility  of  a  por- 
tion of  the  casein.  It  acts  as  an  intestinal  anti- 
septic, affects  in  time  the  flora  of  the  digestive 
canal,  combats  cecal  stasis,  and  lessens  fermen- 
tation. Metschnikoff,  who  attributes  to  these 
fermentations  a  preponderating  role  in  the  econ- 
omy of  the  organism,  does  not  hesitate  to  call 
curdled  milk  the  elixir  of  long  life.  It  is  useful 
in  arthritis  and  to  heavy  eaters  with  big  abdo- 
mens and  cecal  obstructions,  but  only  on  the 
condition  that  it  is  not  added  to  the  ordinary 
diet,  but  takes  the  place  of  other  foods,  as  other- 
wise it  might  have  very  troublesome  effects. 
Ordinary  curdled  milk  offers  the  same  advan- 
tages as  yoghourt,  only,  perhaps,  in  a  some- 
what slighter  degree. 


CHEESE 

CHEESE,  although  a  product  of  milk,  possesses 
quite  different  characteristics.  Its  dietetic  prop- 
erty is  almost  nil,  but  its  food  value  is  great, 
and  plainly  justifies  the  renown  in  which  it  has 
been  held  at  all  times. 

There  are  almost  as  many  different  kinds  of 
cheese  as  there  are  countries  where  cheese  is 
made;  but  they  may  all  be  classed  into  three  or 
four  groups,  according  to  the  different  methods 
of  manufacture,  and  according  to  the  composi- 
tion and  the  properties  which  are,  however, 
almost  identical  in  all. 

The  manufacture  of  cheese  is  pretty  well  the 
same  everywhere,  whether  this  is  accomplished 
by  lactic  fermentation  or  by  the  aid  of  vegetable 
or  calf  rennet.  Coagulation  involves  the  casein, 
nearly  all  of  the  butter,  a  little  of  the  lactose, 
and  a  goodly  portion  of  the  phosphate  of  lime. 
The  acid  salts  stay  almost  entirely  in  the  cheese, 
while  the  basic  salts  remain  in  the  form  or 
mold  in  which  the  cheese  is  made,  whence  is 

134 


CHEESE  135 

derived  that  slight  taste  of  acidity  in  the  rind 
or  crust. 

Coagulation,  produced  by  spontaneous  lactic 
fermentation,  constitutes  the  first  variety,  i.e., 
fresh  unsalted  cheese  (pie-shaped  cheese,  cream 
cheese,  Gervais,  petit  Suisse). 

The  mean  composition  is: 

Carbo-  Available 

Albumin.  Fats.  hydrates.  Ash.  Calories. 

10.80          20.70  3.78          2.00          265 

They  possess  nearly  the  same  properties  as 
curdled  milk,  of  which  we  have  already  spoken. 
We  will  only  mention  that  Gervais  is  particu- 
larly rich  in  butter,  and  that  the  petit  Suisse 
contains  a  considerable  amount  of  kitchen  salt, 
for  which  reason  it  is  not  suitable  for  patients 
suffering  from  Bright3 s  disease. 

With  these  restrictions,  unfermented  raw 
cheese  however,  always  on  the  condition  of 
absolute  freshness,  may  be  recommended  for 
moderate  use  in  the  sick-room.  It  should 
form  a  part  of  the  milk  diet. 

In  most  cheeses  coagulation  is  brought  about 
by  the  aid  of  rennet.  Some  of  them  pass  also 
through  a  more  or  less  prolonged  process  of 
cooking. 


136  WHAT  SHALL   I    EAT  ? 

Second  variety:  Cooked  cheeses  (Emmenthal 
or  Gruyere — ordinarily  known  in  this  country 
as  Swiss  cheese, — Parmesan).  Both  are  excellent 
foods. 

Carbo- 
Albumin.  Fats.  hydrates.          Ash.         Calories. 

Emmenthal...    28.37       28.49       1.43       3.69       400 
Parmesan 39.34        18.97        1.95       4.72       357 

The  percentage  of  albumin,  it  will  be  no- 
ticed, is  exceptionally  high,  which  renders  these 
two  varieties  the  most  nitrogenous  foods  known. 
Meat  and  vegetables  are  outdistanced.  Fats  are 
very  abundant,  for  which  reason  the  food  value 
of  the  Emmenthal  variety,  being  made  of  the 
whole  milk,  exceeds  that  of  Parmesan  in  the 
preparation  of  which  the  milk  is  partly  skimmed. 

The  large  amount  of  salts,  chiefly  chlorid  of 
sodium,  however,  detracts  a  good  deal  from  its 
value. 

These  cooked  cheeses  have  a  mild,  stimulating 
effect  on  the  stomach  and  the  bowels.  They 
are  easily  digested,  wholly  absorbed,  and  possess 
the  same  quality  of  being  readily  assimilated  as 
the  fats  and  carbohydrates.  On  the  other  hand, 
on  account  of  the  large  percentage  of  ash  con- 
tained in  them,  they  are  prone  to  produce,  when 
taken  in  large  quantities,  acidity  in  the  organ- 


CHEESE  137 

ism.  Minkowski  attributes  to  this  cause  the 
striking  prevalence  of  stone  observed  in  Saxony, 
where  cheese  figures  so  largely  in  the  diet  of  the 
inhabitants. 

Very  nourishing,  rich  in  nitrogen,  free  from 
toxic  qualities,  cheap  in  price,  this  variety  of 
cheese  is  a  food  of  great  value,  particularly  so  to 
the  peasant,  to  tourists,  and  to  troops  engaged 
in  field  exercises. 

In  the  sick-room  it  renders  good  services.  It 
has  its  proper  place  in  all  conditions  which  re- 
quire strong  nourishment,  such  as  tuberculosis, 
neurasthenia,  convalescence.  By  its  savory, 
piquant  flavor  it  lends  itself  charmingly  as  a 
means  for  modifying,  in  an  acceptable  and 
effective  manner,  the  milk  diet,  except  in 
Bright'  s  disease  and  in  cardiac  affections. 

In  dyspepsia,  especially  in  the  hyposthenic  form, 
in  enteritis  and  in  enterocolitis  the  easy  assimila- 
tion of  these  cheeses  and  their  peptogenic  and 
antiputrefactive  elements  render  a  valuable  aid. 

The  grated  cheese  sprinkled  on  pastry  and 
farinaceous  foods  forming  the  basis  of  Combe's 
regimen,1  offers  the  double  advantage  of  cor- 


:  "Intestinal  Autointoxication,"  Rebman  Company, 
New  York. 


138  WHAT  SHALL   I    EAT? 

reeling  the  insipid  taste  of  these  preparations 
chiefly  composed  of  salt  and  water,  and  of  sup- 
plying the  proper  proportion  of  nitrogen  and 
fat. 

For  diabetics  they  are  useful  on  account  of 
their  high  alimentary  value  and  the  absence  of 
carbohydrates.  They  are  also  highly  recom- 
mended in  acetonuria. 

In  arthritis  they  must  be  used  with  caution; 
their  acidity  and  high  alimentary  power  are 
here  a  source  of  danger.  The  habit  of  finishing 
every  meal  with  a  bit  of  cheese,  often  enough 
proves  fatal  to  men  of  the  world.  Its  use  should 
be  confined  to  a  specified  amount  in  the  aggre- 
gate for  each  day,  and  must  not  be  looked  upon 
as  a  negligible  quantity. 

Third  variety:  Cheeses  with  an  unbaked  crust, 
whether  they  be  salted,  such  as  Cantal,  Chesh- 
ire, Canadian,  American,  Roquefort,  Dutch, 
or  unsalted,  such  as  Brie,  Bondon,  Camembert, 
Coulommiers,  Gorgonzola,  Livarot,  Mont  d'Or, 
Liederkranz,  etc.,  are  subject  to  the  action  of 
certain  yeasts,  molds,  and  fungous  growths,  the 
nature  and  intensity  of  behavior  of  which  vary 
in  each  particular  brand.  Their  mean  com- 
position is: 


CHEESE  139 

Carbo- 
Albumin.          Fats.        hydrates.     Ash.        Calories. 

Salted  cheeses1...   25.00      25.50      4.4      3.87      366 
Unsalted  cheeses2.    19.90      23.00      4.3      3.40      323 

They  range  about  half-way  between  the 
cooked  and  the  fresh  (white)  cheeses.  During 
the  period  of  maturing  they  undergo  numerous 
transformations,  the  more  pronounced  the  more 
matured  the  cheese,  by  which  their  properties 
are  entirely  changed. 

Their  casein  content  is  partly  peptonized  and 
partly  transformed  with  a  series  of  products 
more  or  less  noxious,  such  as  leucin,  tyrosin, 
amino  acids,  and  ammonia,  whence  they  derive 
their  odors  and  savory  qualities  that  give  each 
cheese  its  peculiar  taste.  Their  fats  are  soluble 
in  alcohol,  glycerin,  and  in  fatty  volatile  acids 
reenforced  with  ammonia,  and  their  lactose  fer- 
ments in  lactic  acid,  alcohol,  and  carbonic 
acid. 

Thus  modified,  the  cheese  preserves  the  quali- 
ties of  its  peptogenic  and  assimilable  substances, 
since  the  diastase  secreted  by  the  yeasts  seems  to 
continue  within  the  intestines  the  digestion  of 
casein;  but  it  thereby  loses  completely  its  char- 

1  Average  of  four  cheeses  quoted. 

2  Average  of  seven  cheeses  quoted. 


140  WHAT   SHALL   I    EAT? 

acter  of  an  antifermentative  and  slightly  toxic 
food. 

A  moderate  slice  of  these  cheeses  is  beneficial 
to  a  normal  constitution,  and  if  taken  at  the  end 
of  the  principal  meal  aids  digestion.  Tubercu- 
lous and  diabetic  patients  can  fall  back  on  them 
with  advantage,  so  long  as  there  are  no  intes- 
tinal, hepatic,  or  renal  complications  present. 

In  dyspepsia,  enter  ocolitis,  arthritis,  heart,  and 
liver  troubles,  and  in  Bright' s  disease,  they  must 
be  avoided;  likewise  in  eczema  and,  in  fact,  in 
all  diseases  of  the  skin. 


FATS  (GREASES)-BUTTER-OIL 

ALTHOUGH  of  different  origin,  yet  these  arti- 
cles should  be  classed  under  one  heading,  be- 
cause they  are  all  composed  of  fatty  substances. 
Of  albumin,  carbohydrates,  and  mineral  bodies 
there  are  but  minute  traces,  likewise  of  the  fatty 
volatile  acids.  We  speak  here  of  the  neutral 
fats  which  are  formed  by  a  mixture  in  variable 
proportions  of  butyrin,  margarin,  stearin,  and 
olein.  These  bodies  are  formed  by  a  union  of 
one  molecule  of  glycerin  with  three  molecules  of 
corresponding  acids,  i.  e. ,  butyric,  margaric,  etc. 

COMPOSITION   AND    PROPERTIES 

Percentage  Available  Point  of 

of  Fat.  Calories.  Melting-. 

Mutton  fat 83.40  790  108 

Beef  fat 81.07  773  105 

Pork  fat 81.85  782  91 

Butter 79.50  752  88 

Olive-oil 90.00  846  35 

a.  Animal  Fats. — These  fats,  however  small 
in  proportion,  form  an  integral  part  of  all  the 
organs.  We  have  seen  that,  no  matter  how  lean 

141 


142  WHAT  SHALL   I    EAT? 

the  meat  may  be,  it  contains  a  certain  amount 
of  fat;  but  it  accumulates  more  richly  in  the 
connective  tissue  around  the  intestines. 

It  is  formed  chiefly  in  the  membranous  layers 
which  control  rather  its  digestibility  than  the 
point  of  melting,  for  which  reason  the  fat  of 
pork  and  lard  is  harder  to  digest  than  beef 
and  mutton  fat. 

As  a  rule,  fat  is  consumed  while  hot,  mixed 
with  the  juice  of  the  meat  or  prepared  with 
various  ingredients  and  condiments  which  only 
add  to  its  objectionable  features. 

b.  Butter. — This  is  formed  by  the  union  of 
the  fatty  globules  of  the  milk.  Besides  a  small 
percentage  of  casein,  lactose,  and  certain  lactic 
salts,  it  contains  also  a  considerable  amount 
of  ferments — bacteria  which  cause  it  to  degener- 
ate quickly  and  grow  rancid,  unless  kitchen  salt 
is  added  in  sufficient  quantities. 

In  hot  weather  particularly,  butter  snould  be 
eaten  only  when  quite  fresh. 

Hot  melted  butter  is  very  hard  to  digest,  be- 
cause the  water  which  separates  the  fat  globules 
has  been  evaporated,  thus  rendering  the  attack 
on  it  by  the  digestive  juices  much  more  diffi- 
cult. —  (Pascault. ) 


FATS  (GREASES)— BUTTER— OIL         143 

Brown  butter,  however,  is  an  exception,  be- 
cause the  high  temperature  under  which  it  is 
prepared  produces  a  partial  separation  of  the 
fats  from  the  acids.  Although  not  equally 
as  well  digested  as  the  fresh  butter,  it  is  pref- 
erable to  hot  butter. 

Oleomargarin  is  an  artificial  substitute  for 
butter.  If  carefully  manufactured  it  is  not 
injurious,  and  if  mixed  with  genuine  butter, 
although  impairing  the  taste  somewhat,  it  does 
not  detract  from  the  digestibility  or  food  value 
of  the  butter  itself.  The  laws,  especially  in  the 
United  States,  relating  to  the  sale  of  oleomar- 
garin  are  stringent  and  strictly  enforced. 

c.  Vegetable  Butter.  — Under  this  name  many 
imitations  of  butter  are  comprised.     They  are 
principally  made  from  the  refined  oils  of   the 
cocoanut.     The  taste  is  rather  insipid.     Among 
the   better   classes   these   preparations   are   but 
little   known,   but   the   poor  people  find   them 
economical  as  well  as  acceptable,  for  they  are 
cheap  and  keep  well.     Among  vegetarians  they 
have  found  great  favor,  and  in  many  armies  of 
Europe  they  are  in  use  on  account  of  the  wide- 
spread adulteration  of  lard. 

d.  Olive-Oil. — This  is  the  finest  oil  for  table 


144.  WHAT  SHALL  I   EAT? 

use.  It  is  principally  composed  of  olein  and 
margarin  with  slight  traces  of  stearin.  In  the 
southern  countries  of  Europe  it  takes  the  place 
of  butter  for  cooking  purposes.  Many  authori- 
ties contend  that  hot  olive-oil  does  not  carry  the 
same  disadvantages  which  are  attributable  to 
hot  butter,  and  that  dry  and  crisp  fries  made 
in  thoroughly  heated  olive-oil  are  very  easy  of 
digestion. 

REACTIONS 

a.  Digestive. — Although  the  fats   escape  al- 
most completely  the  action  of  the  gastric  juices, 
they  yet  exert  an  important  influence  on  the 
digestive  powers  of  the  stomach  in  general,  for 
they  diminish  the  peptic,  especially  the  hydro- 
chloric secretions,  and  retard  the  opening  of  the 
pylorus   and   the   evacuations   of    the   digested 
food.     But  they  ferment  easily  and  create  irri- 
tating acids. 

Their  action  on  the  intestines  is  less  marked. 
They  provoke  there  rather  pancreatic  and  biliary 
secretions,  and  gently  slacken  peristalsis.  But 
as  in  the  stomach,  here,  too,  they  are  subject  to 
fermentation. 

b.  General. — When  the  fats   have  once  en- 


FATS  (GREASES)— BUTTER— OIL         145 

tered  the  general  circulation,  they  are  accumu- 
lated in  the  liver,  infiltrating  it  in  a  normal 
physiological  manner. 

Thence  they  are  gradually  distributed  through-/ 
out  the  tissues.  It  is  easy,  therefore,  to  under- 
stand how  an  excessive  use  of  fat  is  able  to 
choke  the  hepatic  parenchyma. 

The  fats  play  an  important  role  in  the  process 
of  nutrition,  chiefly  by  their  caloriferous  power, 
for  one  gram  of  fat  gives  on  an  average  double 
the  number  of  calories  than  one  gram  of  albu- 
min and  carbohydrates  will  produce.  If  the 
latter  are  superior  in  their  action  on  the  muscu- 
lar system  by  force  of  the  isoglucoric  coefficient, 
the  fats  excel  them  in  the  struggle  against  the 
loss  of  heat.  That  is  the  reason  why  the  in- 
habitants of  cold  climates  consume  such  vast 
amounts  of  fatty  substances.  The  fats  do  not 
only  afford  much  fuel,  but  they  restrict  also  the 
waste  of  energy,  and  influence  the  economical 
principles  within  the  system  almost  as  much  as 
do  the  ternary  bodies.  They  also  furnish,  well 
nigh  exclusively,  the  material  for  our  reserve 
forces.  Excessive  alimentation  modifies  but 
little  the  surplus  of  nitrogen  and  sugar  in  the 
organism,  because  everything  that  is  not  burned 


146  WHAT  SHALL   I    EAT? 

up  and  consumed  is  converted  into  fat  or  adipose 
tissue.  Hence  it  is  that  overfeeding  becomes  a 
danger.  A  surcharge  of  fat  jams  the  organs, 
obstructs  their  movements,  makes  the  circula- 
tion sluggish,  and  prepares  the  way  to  physical 
degeneracy.  These  dangers  are  frequently  in- 
creased by  cardiac  localization. 

c.  Excretory. — Fat  is  not  discharged  from 
the  system  in  the  same  manner  as  water  or  car- 
bonic acid.  When  it  does  not  ferment  it  does  not 
molest  the  kidneys.  But  the  fatty  acids  which 
it  produces  are  more  troublesome,  as  they  irritate 
the  skin  through  which  they  are  eliminated. 

INDICATIONS   AND    CONTRAINDICATIONS 

In  the  normal  individual  the  absorption  of  fat 
is  the  strongest  protection  against  the  loss  of 
caloric  force.  In  cold  climates  a  larger  amount 
of  it  is  required,  while  in  the  warm  countries 
the  need  for  it  is  much  restricted. 

In  the  temperate  zones  fatty  foods  should  be 
used  with  moderation,  especially  during  the 
heated  term,  if  gastric  troubles  are  to  be  fore- 
stalled. This  precaution  is  indispensable  in 
patients  who  require  a  calorific  diet,  such  as 
consumptives  and  diabetics. 


FATS  (GREASES)— BUTTER— OIL         147 

It  would  appear  that  fat  constitutes  an  emi- 
nent nourishment  in  acute  diseases  in  which  the 
caloric  losses  are  so  enormous;  but,  unfortu- 
nately, in  these  very  conditions  it  is  badly  tol- 
erated and  is  therefore  not  absorbed,  for  which 
reason  it  has  to  be  eschewed  altogether. 

In  prolonged  chronic  fever  cases,  however,  its 
use  is  fully  justified. 

In  tuberculosis  a  diet  of  fats  becomes  a  neces- 
sity, and  it  is  for  the  physician  to  find  the  form 
most  suitable  to  the  individual  case:  cream, 
fresh  butter,  mayonnaise  of  fat  liver,  etc.  The 
benefit  derived  can  easily  be  measured  by  the 
increase  in  the  weight  of  the  patient,  and  by 
a  decrease  in  the  losses  of  nitrogen  and  phos- 
phorus. But,  while  the  portions  allowed  should 
be  generous,  excess  must  be  avoided.  Much 
depends  on  the  size  of  the  stomach  of  the  pa- 
tient. From  100  to  150  grams  per  day  should 
be  sufficient.  —  (Laufer. )  If  this  figure  is  ex- 
ceeded, a  momentary  but  too  rapid  improve- 
ment will  be  obtained,  and  the  gastric  troubles 
and  diarrhea  that  are  apt  to  follow  will  do  more 
harm  than  good  in  the  end. 

In  diabetes  fats  are  equally  useful,  for  the  pa- 
tient will  draw  from  them  rather  than  from  the 


148  WHAT  SHALL   I    EAT? 

albuminoids  his  daily  ration  of  nutriment;  and 
in  the  majority  of  cases  they  are  well  tolerated. 
Von  Noorden  fixes  the  daily  ration  from  150  to 
200  grams.  Not  only  fresh  butter  and  fresh 
cream,  but  also  meats  and  fatty  fish,  with  sea- 
sonings rich  in  fat  may  be  requisitioned.  Later 
on  we  shall  see  that  one  of  the  advantages  of 
vegetables  consists  in  the  fact  that  large  quanti- 
ties are  easily  tolerated. 

In  arthritis  nothing  is  to  be  gained  by  a  ca- 
lorific diet  which  retards  the  process  of  digestion 
and  produces  so  easily  putrefaction  in  the  atonic, 
sluggish  tube.  Animal  fats  must  be  strictly 
interdicted,  making  some  allowance  of  a  moder- 
ate use  of  butter  and  oil.  The  same  holds  good 
for  gout,  and  above  all  in  obesity,  although  in 
the  latter  case  fats  should  not  be  feared  any 
more  than  carbohydrates. 

In  diseases  of  the  liver  the  use  of  fat  should 
be  limited  for  fear  of  overcharging  the  paren- 
chyma. The  limitation  is  absolute  in  all  dis- 
eases of  insufficiency,  in  Laennec's  cirrhosis,  and 
in  hyperhepatic  afflictions. 

In  lithiasis  certain  fats,  by  force  of  their 
cholagogic  action,  are  great  favorites ;  for 
instance,  olive-oil,  especially  when  taken  in 


FATS  (GREASES)— BUTTER— OIL         149 

the  morning,  a  spoonful  in  coffee,  or  by  it- 
self. 

Whenever  there  is  a  suspension  or  a  decrease 
of  pancreatic  fluid  an  analysis  of  the  feces  will 
show  that  the  fats  are  badly  dissolved  and  but 
little  absorbed.  In  all  such  cases  they  must  be 
rigidly  excluded  from  the  diet. 

In  eczema,  acne,  and  all  skin  eruptions,  which 
are  due  to  bad  intestinal  functions,  all  greasy 
cooking,  all  fries,  all  sauces  and  gravies  should 
be  avoided.  Fresh  butter  may  be  allowed. 

Whether  dyspeptics  may  partake  of  fatty  sub- 
stances depends  on  the  conditions  presenting 
themselves  in  each  individual  case.  In  dilation 
with  atony  and  fermentations  they  are  to  be 
shunned.  In  nervous  and  intestinal  dyspepsia 
they  are  often  badly  tolerated;  oil,  fresh  butter 
and  fresh  cream  in  small  quantities  may  be  per- 
mitted, but  hot  butter  and  hot  grease  should  be 
scratched  off  the  menu.  All  foods  should  be 
merely  cooked  in  water  with  salt,  and  seasoned 
with  a  little  butter  and  cheese  on  the  plate  when 
on  the  table. 

These  precautions  refer  also  to  hyperchlor- 
hydria.  Fresh  butter  and  oil  have  a  sedative 
effect;  the  latter,  especially,  is  well  tolerated, 


150  WHAT  SHALL   I    EAT? 

and,  when  taken  in  quite  large  quantities,  will 
soothe  pain  and  suffering.  A  very  good  recipe 
for  this  ailment  is  a  mayonnaise  sauce  made  of 
olive-oil  and  the  yolk  of  an  egg. 


EGGS 

Albuminoids 7.371 

Fats 6.20— Chlorkl  .    0.046 

Carbohydrates...    0.00 — Purin...    0.0 

Ash 0.532 

Available  calories  =  90 

Eggs  have  at  all  times  been  a  staple  article 
of  food.  Because  they  are  easy  to  digest  they 
occupy  a  predominant  place  on  the  menus  of  the 
sick  chamber. 

The  egg  is  composed  of 

Shell 7.2 

White  of  egg 35.4 

Yolk 17.4 

The  average  weight  is  about  60  grams. 

The  shell  consists  of  lime  salts.  Certain 
authorities  have  advocated  that  after  eating  the 
egg,  the  best  thing  to  do  with  the  shell  is  to 
pound  it  into  a  powder  and  swallow  it.  This 

1  These  figures  do  not  refer  to  100  grams  or  100  per  cent,  but 
only  to  the  composition  of  eggs,  i.e.,  the  average  of  60  grams. 

2  That  is  without  the  shell. 

151 


152  WHAT  SHALL   I    EAT? 

certainly  would  be  an  economical  way  of  sup- 
plying the  system  with  lime;  but,  apart  from 
the  fact  that  intestinal  absorption  would  be 
rather  incomplete,  we  have  grave  doubts  whether 
such  an  ingestion  would  not  be  injurious  to  the 
canal  itself  and  seriously  involve  the  appendix. 

The  white  of  egg  is  almost  wholly  composed 
of  albumins,  viz. :  ovoglobulin  and  another  al- 
most analogous  to  fibrinogen.  Of  mineral  sub- 
stances there  are  only  traces,  apart  from  silica, 
of  which  there  is  abundance.  The  ash  is  al- 
kaline. 

In  the  yolk  fats  are  predominant:  31.40  per 
cent  as  against  16.12  percent  in  albuminoids. 
These  are  formed  of  vitalin  and  nucleo-proteids. 
The  vitalin  is  soluble  in  albumin  and  in  lecithin. 
The  nucleo-proteids  consist  of  one  part  of  albu- 
min and  another  part  of  strongly  phosphorated 
nuclein,  or,  more  properly  speaking,  of  para- 
nuclein.  This  difference  is  not  without  im- 
portance, for  the  paranucleins  do  not  contain 
any  xanthic  bases.  Eggs  have  no  action  on  uric 
excretions.  —  (Fauvel. )  The  fats  consist  of  olein, 
margarin,  cholesterin,  and  lecithin.  The  latter 
is  present  to  a  large  extent,  for  which  reason 
natural  medication  with  the  yolk  of  egg  (of 


EGGS  153 

which  one  alone  may  contain  as  much  as  two 
grams  of  lecithin)  is  preferable  to  the  use  of  the 
artificial  lecithins  sold  by  chemists  and  drug- 
gists. This  exceptional  abundance  of  phos- 
phorated paranuclein  explains  the  fact  that  the 
yolk  of  egg  is  one  of  the  bodies  richest  in  organic 
phosphorus. 

Iron  is  also  present  to  a  large  extent.  It  is 
found  in  the  form  of  Bunge's  hematogen.  The 
ash  is  acid,  owing  to  the  presence  of  phosphoric 
acid;  but  this  acidity  is  more  than  compensated 
for  by  the  alkalinity  of  the  white  of  the  egg. 

Resume. — The  whole  of  the  egg,  white  and 
yolk  together,  is  a  food  equally  rich  in  fats  and 
in  nitrogen,  alkalizing,  abounding  in  phos- 
phorus, iron,  and  silica.  The  yolk  contains 
more  fats  than  nitrogen,  much  iron,  and  a 
large  percentage  of  phosphorus;  only  Parmesan 
cheese  and  a  few  rare  green  vegetables  contain 
more  phosphorus.  The  food  value  is  consid- 
erable, reaching  as  high  as  90  calories.  An 
egg  is  equal  to  40  grams  of  meat  and  nearly 
150  grams  of  milk. 

The  yolk  of  an  egg  represents  61  calories. 


154  WHAT  SHALL   I    EAT? 

METHODS   OF   USING   AND   PREPARING   EGGS 

Eggs  are  eaten  in  a  hundred  different  ways; 
every  country  has  its  own  formulas  and  recipes. 
In  the  kitchen,  the  white  as  well  as  the  yolk  is 
utilized  in  the  preparation  of  all  kinds  of  dishes. 
It  is  beyond  our  scope  to  refer  to  every  one  of 
these,  but  they  are  all  pretty  equally  commend- 
able from  an  hygienic  standpoint. 

1.  The  simplest  method  is  to  eat  the  egg 
without  any  preparations  at  all.  So  long  as  the 
egg  is  quite  fresh  it  is  pleasant  to  consume.  In 
this  condition  it  is  easily  absorbed  by  the  econ- 
omy. A  raw  egg  swallowed  whole  before  din- 
ner does  not  spoil  the  appetite  and  slips  almost 
unnoticed  into  our  daily  allowance. 

Not  everybody,  however,  can  eat  raw  eggs. 
So  the  common  method  of  serving  eggs  is  boiled 
soft  in  the  shell.  This  is  wholesome  food,  espe- 
cially when  coupled  with  a  few  slices  of  bread 
and  butter  or  buttered  toast.  Arthritic  patients 
should  never  forget  that  two  soft-boiled  eggs 
with  60  grams  of  bread  and  5  grams  of  butter 
represent  370  calories,  i.e.,  about  one-sixth  of 
an  average  daily  allowance  of  food. 

Hard-boiled  eggs,   the   principal  components 


EGGS  155 

of  cold  luncheons,  snacks,  and  picnics,  are  rather 
hard  to  digest,  are  very  filling,  and  cause 
thirst;  but  when  sliced  and  mixed  with  a 
salad  they  very  happily  enhance  the  nutritive 
quotient. 

The  addition  of  hot  butter  in  making  fried 
eggs,  scrambled  eggs,  buttered  eggs,  and  ome- 
lets, detracts  somewhat  from  their  hygienic 
quality,  and  they  are  not  too  easily  tolerated  by 
delicate  stomachs. 

2.  The  carbohydrates  make  the  most  judicious 
combinations   with  eggs,   because   the   two   to- 
gether form    an   ideal   nutriment.     An  omelet 
with  potatoes,   although  somewhat  hard  to  di- 
gest, makes  an   excellent   dish   for   the   robust 
stomachs   of   laboring   men.      Most   appetizing 
and  easy  to  digest  are  omelets  with  preserves. 
But  "omelettes  au  rhum"  and  "omelettes  souf- 
flees"  are  too  heavy  for  a  delicate  digestion. 

Meat,  ham,  and  bacon  omelets  make  heavy 
dishes  and  require  strong  digestive  organs. 

3.  Invalids  and  sick  persons  tolerate  eggs  best 
when  mixed  with  some  liquid.     They  may  be 
beaten  up  with  milk,  soup,  bouillon,  and  choco- 
late, or  coffee  and  milk.     Sometimes  the  yolk 
only  is  used.     If  the  white  of  the  egg  is  also 


156  WHAT  SHALL   I    EAT? 

used  the  liquid  must  be  allowed  to  cool  off 
to  at  least  140°,  or  the  white  of  the  egg  will 
coagulate,  which  is  equally  offensive  to  the  eye 
as  it  is  unpleasant  to  the  palate  of  the  patient. 

For  some  time  a  mixture  of  the  yolk  of  the 
egg,  white  sugar  and  water  was  thought  to  act 
as  a  substitute  for  mother's  milk. 

Martini  has  proposed  for  nurslings  the  follow- 
ing formula: 

The  yolk  of  one  egg 15  grams 

Sugar  of  milk 5      " 

Water 100      " 

But  aside  from  the  fact  that  the  mineral  sub- 
stances are  not  present  in  their  proper  propor- 
tions, this  mixture,  if  administered  for  any 
length  of  time,  will  cause  flatulency  and  other 
gastrointestinal  complications. 

To  be  brief,  we  recommend  here  two  prepara- 
tions which  are  worthy  of  mention. 

Mulled  eggs  or  egg-flip.  Beat  up  the  yolks 
of  two  eggs  with  one  ounce  of  powdered  su- 
gar until  the  mixture  whitens;  add  a  glass 
of  hot  water,  stir  lively,  and  then  add  one  or 
two  teaspoonfuls  of  brandy.  Drink  as  hot  as 
possible. 


EGGS  157 

The  second  is  more  difficult  to  make.  Mar- 
tinet gives  this  formula: 1 

First:  Mix  in  an  earthen  vessel  (it  is  important 
that  no  metallic  utensil  be  used)  the  yolks  of  five 
eggs  with  60  grams  of  powdered  sugar.  Beat 
this  mixture,  adding,  gradually,  a  generous 
wineglassful  of  muscatel  or  old  sherry. 

2.  Add  a  small  stick  of  vanilla,  a  bit  of  cinna- 
mon  bark,  and   a   small   piece  of   lemon-peel. 
Put   the  whole   over  a  slow  fire,  all  the  time 
beating,    until  it    comes   almost   to   a    boiling 
point  and  quite  frothy. 

3.  Now  strain  off  the  vanilla,  cinnamon,  and 
lemon-peel.      Put    the    earthen   vessel    into   a 
stewing-pan,    surrounding   it   with    hot   water, 
and,  still  beating  the  contents,  add  slowly  and 
carefully  a   teaspoonful  or  two   of   maraschino 
until   the   mixture   stiffens.      Drink    hot   with 
some  light  cake,  biscuits,  or  crackers. 

This  concoction  is  called  in  France  and  Italy 
zabaglione,  in  France  also  sabayon.  If  pre- 
pared according  to  the  directions  given  above,  it 
consists  approximately  of  20  grams  of  albumin, 
30  grams  of  fat,  70  grams  of  carbohydrates,  22 

!A.  Martinet:  "Les  aliments  usuels, "  1909. 


158  WHAT  SHALL   I    EAT? 

grams  of  alcohol,  and  gives  about  800  calories 
(l  liter  of  milk  giving  about  670  calories). 

4.  The  digestibility  of  cakes  and  of  side  dishes, 
and  their  nutritive  qualities,  depend  largely  on 
the  quantity  of  eggs  used  in  their  composition. 

The  white  of  egg,  beaten  or  whipped  into 
froth  or  "snow,"  is  largely  used  in  pastry  cook- 
ing. Later  on  we  will  discuss  the  possible  dan- 
gers that  lurk  in  this  preparation. 

CHANGES 

Eggs,  like  meat,  fish,  and  all  other  nitroge- 
nous foodstuffs,  spoil  quickly.  This  defection,  of 
course,  strongly  affects  their  quality.  Candling 
is  not  a  sure  means  for  determining  their  fresh- 
ness. The  best  way  to  find  out  whether  an  egg 
is  new-laid  or  not  is  by  plunging  it  into  cold 
water.  If  fresh  it  will  lie  flat  on  its  side  (or 
horizontally)  in  the  water;  if  eight  days  old 
it  will  rise  at  an  angle  of  45°;  if  three  weeks  old 
at  an  angle  of  75°;  if  a  month  old  it  will  stand 
upright;  if  older  it  rises  to  the  surface. 

Rotten  eggs  are  easily  detected  by  their  in- 
ternal appearance  and  their  odor,  which  is  due 
to  the  presence  of  sulphurous  hydrogen.  Mi- 
crobes easily  pass  through  the  porous  shell  and 


EGGS  159 

impregnate  the  albumin  with  dangerous  poisons, 
which  successfully  defy  the  sense  of  vision  and 
smell. 

It  is  well  to  bear  in  mind  the  many  cases 
of  ptomain-poisoning  caused  by  eating  eclairs, 
cream-puffs,  and  similar  articles  purchased  of 
confectioners.  By  far  the  larger  part  of  con- 
fectionery bought  in  the  ordinary  pastry-shops 
contains  the  white  of  eggs  the  age  of  which  is 
very  doubtful,  and  cream  cannot  be  improved 
by  cooking,  because  the  ptomains  are  not 
destroyed  by  heat.  Heat,  indeed,  develops 
ptomains,  a  fact  which  is  clearly  demonstrated 
by  the  frequency  of  ptomain-poisoning  in  the 
summer  months.  The  only  effective  way  to 
prevent  and  escape  these  dangers  is  really  to 
abstain  altogether  from  confectionery  purchased 
from  the  makers,  at  any  rate  during  the  heated 
term. 

REACTIONS 

a.  Digestive.  — Eggs  are  easily  digested.  They 
put  but  little  strain  on  the  action  of  the  stomach, 
as  they  remain  only  a  short  time  in  it,  if  soft- 
boiled  at  the  utmost  from  one  to  two  hours,  the 
minimum  length  of  time  in  the  case  of  any  solid 


160  WHAT  SHALL   I    EAT? 

food;  but  from  two  to  three  hours,  if  hard 
boiled  or  in  the  shape  of  omelets. 

The  absorption  by  the  bowels  is  also  complete, 
i.e.,  97  per  cent  of  the  albumin  and  95  per  cent 
of  the  fats.  But  little  residue  is  left  behind. 
Eggs  give  off  a  great  deal  of  heat,  and  ferment 
easily,  but  not  as  readily  as  meat. 

Certain  infants,  arthritic  by  heredity,  present 
veritable  idiosyncrasies  as  regards  the  yolk  of 
eggs.  This  condition,  however,  generally  disap- 
pears with  age.  We  had  a  child  of  five  years  of 
age  under  observation  which  could  not  support 
more  than  7  or  8  drops.  If  a  larger  dose  was 
given,  diarrhea  and  violent  vomiting  would  set 
in. 

b.  General.  — The  action  of  eggs  on  the  liver 
has  given  rise  to  endless  discussion,  and  seems  to 
be  governed  by  the  amount  consumed.  If  in 
small  quantities,  the  action  on  the  biliary  tract 
seems  to  be  favorable.  Experiments  made  by 
Brun  with  the  yolk  on  animals  have  proved  the 
maximum  of  biliary  excretions.  The  so-called 
danger  of  cholesterin  precipitating  calculi  does 
not  exist  in  reality,  because  alimentary  choles- 
terin is  not  eliminated  through  the  bile.  Du- 
fourt  injected  as  much  as  4  grams  of  cholesterin 


EGGS  161 

in  the  stomach  of  a  dog,  but  could  find  no 
difference  in  the  quantity  of  biliary  choles- 
terin. 

If  large  quantities  are  eaten,  eggs  may  be- 
come injurious,  as  the  liver  becomes  surcharged 
not  only  with  nitrogenous  bodies,  but  also  with 
fat  and  lecithin.  Chemical  analysis  of  foies 
gras  shows  how  quickly  lecithin  is  accumulated 
in  the  liver. 

The  nervous  system  derives  from  the  lecithin 
of  eggs,  which  is  rich  in  phosphorus,  a  marked 
stimulus,  perhaps  even  rather  exaggerated. 

Nutrition,  of  course,  is  strongly  influenced  by 
lecithin.  Many  experimenters  have  studied  its 
action  on  the  organism,  and  all  have  obtained 
the  same  results.  Lecithin  moderates  absorp- 
tion and  diminishes  oxidation. 

It  is  also  an  aid  to  assimilation,  it  regulates 
the  reserve  of  nitrogen  and  phosphorus,  and 
distributes  throughout  the  economy  an  albumin 
which  is  rich  in  phosphorus  and  possesses  pow- 
erful resisting  qualities.  All  this  again  depends 
on  the  amount  consumed,  as  has  been  shown  by 
Robin  and  Binet.  With  six  eggs  per  day  one 
can  observe  how  the  metabolism  in  consump- 
tives is  diminished,  i.e.,  the  output  of  carbonic 


162  WHAT  SHALL   I    EAT? 

acid  as  well  as  that  of  oxygen.  But  with  a 
dozen  eggs  per  day  it  is  raised,  carbonic  acid 
and  oxygen  both  being  increased. 

c.  Renal. — In  former  days  eggs  were  forbid- 
den in  albuminuria.  The  blame  was  laid  on  the 
white  of  the  egg.  Experiments,  however,  made 
under  more  favorable  conditions  have  corrected 
this  error.  Certain  patients  suffering  from 
Bright 's  disease  can  eat  as  many  as  ten  eggs 
a  day  without  the  slightest  modification  of  the 
albuminuria,  whilst  in  others  there  is  a  diminu- 
tion. Nevertheless,  the  influence  on  the  renal 
functions  is  not  altogether  favorable.  If  the 
albumin  is  light  and  a  little  toxic,  it  is  apt 
to  provoke  fermentation.  On  the  other  hand, 
lecithin  contains,  in  its  molecular  composition, 
a  given  amount  of  neurin  which  possesses  toxic 
qualities. 

INDICATIONS   AND    CONTRAINDICATIONS 

The  egg  is  preeminently  a  food  for  growth 
and  physical  development.  Under  this  title  it 
constitutes  for  the  infant  one  of  the  most  valu- 
able resources,  and  should  take  an  important 
place  in  the  list  of  infant  feeding  immediately 
the  baby  has  been  weaned.  Note,  however, 


EGGS  163 

that  in  hereditary  arthritis  the  bowels  must  be 
carefully  watched.  Eggs  are  appropriate  food 
m  rickets,  anemia,  diminished  mineral  metabolism, 
where  phosphorus,  potash,  iron,  and  silica  are 
wanted.  Milk  supplies  the  necessary  amount  of 
lime  which  is  wanting  in  the  egg. 

In  dyspepsia  and  hyperchlorhydria  it  does 
good  service.  Its  presence  affords  but  feeble 
secretion  and  fixes  a  large  amount  of  free  acid. 
Patients  who  are  troubled  with  crises  of  linger- 
ing pains  will  derive  much  soothing  effect  from 
swallowing  a  fresh  raw  egg.  In  dyspepsia  from 
insufficiency,  in  atony  and  dilatation,  eggs 
should  be  touched  with  the  utmost  caution,  if 
at  all.  They  should  be  taken  in  very  small 
quantities  only,  and  never  with  hot  butter. 
The  sulphur  in  the  yolk  quickly  undergoes  pu- 
trefaction when  the  gastric  juices  are  deficient. 

In  intestinal  troubles  and  laxness  of  the  bowels 
eggs  are  well  tolerated.  In  all  cases  of  com- 
mon or  specific  diarrhea,  summer  complaint,  and 
dysentery,  soft-boiled  eggs  are  wholesome  food, 
likewise  in  enter ocolitis.  Constipated  persons 
will  find  them  troublesome,  as  they  ferment 
too  easily. 

In  Bright' 's  disease  or  cardiac  affections  they 


164  WHAT  SHALL   I    EAT? 

may  be  taken  either  in  the  shell  or  in  the  shape 
of  side  dishes;  but  the  stomach,  often  so  very 
sluggish  in  these  cases,  may  claim  the  same  pre- 
cautions as  in  dyspepsia  from  insufficiency. 

Finally,  the  egg  is  a  food  for  reconstituting 
the  system.  It  limits  the  losses  in  the  economy 
and  adds  the  fixation  of  nitrogen  and  phos- 
phorus, wherein  consist  its  great  merits.  It 
ought  to  be  a  dish  of  predilection  to  all  who  get 
easily  overheated  and  who  have  weak  powers  of 
assimilation.  In  cancer,  neurasthenia,  and  phos- 
phaturia  the  large  content  of  phosphorus  shows 
its  proper  place.  Likewise  in  diabetes,  in  all 
forms  of  emaciation  and  consumption,  and  in 
anemia;  in  the  latter  case  on  account  of  the 
heavy  percentage  of  iron  present.  To  convales- 
cents who  need  remineralization  eggs  should  be 
recommended. 

Tuberculous  patients  should  eat  eggs,  especi- 
ally the  yolk,  in  large  quantities,  for  unto  them 
they  are  not  only  a  food  but  a  medicament,  in- 
deed.1 To  facilitate  tolerance  one  has  to  have 
recourse  frequently  to  all  sorts  of  artifices:  A 

'Recent  experiments  made  by  Calmette  into  the  lecithino- 
philic  properties  of  the  tubercle  bacillus  establish  a  new  argu- 
ment in  favor  of  the  employment  of  the  yoke  of  the  egg  in 
tuberculosis. 


EGGS  165 

new-laid  egg  sucked  before  dinner;  the  yolk 
beaten  up  in  cacao,  or  in  beef-tea,  milk,  or 
claret,  also  in  beer,  sabayon,  etc. 

But  care  must  be  had  not  to  sin  by  excess. 
If  certain  patients  have  attempted  to  cure  them- 
selves by  eating  eighteen  eggs  a  day,  we  con- 
sider such  an  undertaking  fraught  with  many 
dangers.  Six  per  day  is  considered  the  best 
average  by  Robin  and  Binet.  Moreover,  there 
should  be  intervals  of  rest  from  time  to  time. 

Arthritic  patients  should  make  moderate  use 
of  eggs,  one  at  a  time  only.  Monteuuis  very 
tritely  says:  "The  egg  holds  the  first  place 
among  the  aliments  for  overfeeding. ' ' 

In  gout,  eggs  are  useful  because  they  contain 
no  uric  acid — in  fact  they  assist  in  the  elimina- 
tion of  paranucleins  by  the  aid  of  thymic  acid. 

In  liver  complaints  no  special  directions, 
either  one  way  or  the  other,  are  required.  We 
have  already  mentioned  that  the  cholesterin  of 
the  egg  does  not  affect  gall-stones. 


CEREALS 

WITH  the  cereals  we  pass  from  the  animal 
into  the  vegetable  kingdom,  which  alone  can 
truly  furnish  us  with  energy,  because  it  alone 
can  utilize  the  solar  heat  for  the  purposes  of  re- 
building the  organic  structures  with  mineral 
substances,  the  combustion  of  which  develops 
the  calories  necessary  for  our  existence.  The 
energy  which  we  draw  from  the  animal  king- 
dom is,  after  all,  only  borrowed  from  the  vege- 
table kingdom  and  simply  reaches  us  in  an 
indirect  way.  No  wonder  then  that  the  vege- 
tables occupy  such  an  important  if  not  unique 
position  in  our  food  list.  If  we  consider  the 
calorific,  the  nitrogenous,  and  the  mineral  values 
of  our  foodstuffs,  we  shall  find  that  at  least  two- 
thirds  of  each  of  them  are  derived  from  the 
plants,  and  if  the  proportion  of  fats  is  smaller, 
this  is  outweighed  by  90  per  cent  when  carbohy- 
drates come  into  consideration. 

Among  the  vegetable  foods,  the  cereals  easily 
are  in  the  front  rank,  and  it  is  quite  useless  to 

166 


CEREALS  167 

expatiate  on  the  importance  of  a  class  of  nutri- 
ents which  comprises  bread  and  rice,  staple 
articles  that  have  served  humanity  as  the  pillars 
of  nourishment  from  time  immemorial. 

GENERAL    CHARACTERISTICS 

The  composition  in  all  of  them  is  of  a  similar 
character,  the  differences  being  very  insignifi- 
cant, for  which  reason  they  can  be  all  classified 
under  certain  properties  which  are  common  to 
them  all. 

Car  bo- 
Albumin.        Fats.         hydrates.         Ash.          Calories. 

Barley 10.77  0.67  68.66  1.54  335.0 

Oats 12.371  6.03  65.77  1.361  380:0 

Rice  (unground)     7.192  1.76  72.59  0.892  349.5 

Maize 7.17  3.04  70.41  1.03  348.0 

Rye 7.71  1.23  73.47  0.83  346.0 

Buckwheat 5.90  1.30  74.34  0.80  342.0 

Wheat 10.12  1.00  72.73  0.43  352.0 

The  carbohydrates  come  to  the  front  and,  as 
is  the  case  with  vegetables  generally,  outstrip 
the  element  of  fat  or  nitrogen.  Neither  is  any 
other  part  so  largely  represented  elsewhere  as 
in  the  cereals  and  their  derivatives.  The  car- 
bohydrates are  principally  present  in  the  form 

'Purins  =  0.06.  2Purins  =  0. 


168  WHAT   SHALL   I    EAT? 

of  starch,  which  is  contained  in  the  grain  and 
varies  in  form  and  coarseness  according  to  the 
quality  of  the  flour. 

The  albumin,  though  smaller  in  percentage, 
differs  materially  in  its  composition  from  the 
animal  albumin.  It  imposes  a  much  heavier  task 
on  the  digestive  ferments  and  is  much  harder  to 
absorb.  If  the  coefficient  of  nitrogenous  intes- 
tinal utilization  is  about  96  for  the  meat,  it  is 
only  about  80  for  the  cereals. 

The  nuclein  exists  only  in  the  skin  of  the 
grain,  that  is,  in  the  bran.  Flour  well  bolted 
contains  merely  traces  of  it,  if  we  except  oat- 
meal. Cereals  do  not  belong  to  that  class  of 
foods  which  generate  uric  acid. 

The  percentage  of  fats  is  very  small,  but  the 
contents  of  lecithin  claims  attention. 

The  mineral  bases  are  well  represented,  the 
cereals  furnishing  more  than  one-fifth  of  our 
daily  ration  of  mineral  matter.  Potash  and 
phosphorus  are  predominant;  magnesium  is,  as  a 
rule,  quite  abundant,  often  exceeding  the  per- 
centage of  lime;  iron  exceeds  in  rye  and  barley, 
but  the  amount  of  sodium  chlorid  is  very  small. 

Like  all  vegetable  matters,  the  cereals  con- 
tain cellulose,  which  serves  as  a  wrapper  for  the 


CEREALS  169 

nutritive  bodies.  It  is  very  much  reduced, 
however,  in  the  process  of  grounding  and  bolt- 
ing. The  little  of  it  that  remains  in  the  flour 
resists  almost  completely  the  attacks  of  the  di- 
gestive juices. 

On  account  of  the  small  amount  of  water  pre- 
sent the  nutritive  value  is  high;  neither  does 
the  insufficiency  of  intestinal  absorption  affect 
this  to  any  extent.  But  the  method  of  prep- 
aration modifies  it  largely.  It  will  be  easily 
understood  that,  while  bread  is  one  of  our  most 
substantial  foods,  a  soup  or  broth  made  of  oats, 
for  instance,  is  such  in  a  much  lesser  degree. 

The  methods  of  preparation  vary  a  great  deal. 
Sometimes  the  grain  is  only  decorticated,  like 
rice,  or  oatmeal,  or  pearl-barley,  in  which  shape 
they  are  used  for  making  soups,  puddings,  and 
all  kinds  of  side  dishes;  or  they  are  crushed  into 
a  coarse  flour  from  which  soft  foods  are  made, 
such  as  cream  of  rice,  gruel,  and  groats;  or  they 
are  turned  by  an  elaborate  process  into  a  fine 
meal  for  making  bread  and  pastry.  All  these 
different  preparations  are  well  tolerated  by  the 
stomach,  as  well  as  by  the  intestinal  canal. 

Bread  will  receive  particular  attention  later 
on. 


170  WHAT  SHALL   I    EAT? 

The  reactions  of  the  cereals  are  almost  exclu- 
sively due  to  amylaceous  bodies  and  to  lecithin. 
They  pass  through  the  stomach  almost  without 
calling  into  service  the  secretory  process;  the 
starch  succumbs  simply  to  the  action  of  the 
saliva.  The  albumin,  it  is  true,  is  harder  to 
digest;  but  on  account  of  the  ternary  bodies 
there  is  but  a  small  proportion  present.  More- 
over, farinaceous  foods  seem  to  have  a  whole- 
some influence  on  the  glandular  and  muscular 
activity  of  the  stomach.  Beauvy  found  from 
the  examination  of  the  vomitings  of  nurslings 
that  the  addition  of  farinaceous  foods  makes 
a  finer  and  more  granular  coagulum  in  the 
milk. 

In  the  bowels,  however,  the  action  is  more 
pronounced,  and  requires  a  surfeit  of  pancreatic 
secretion.  Slowly  absorbed  and  assimilated 
throughout  the  length  of  the  intestinal  tube, 
the  cereals  are  really  a  food  for  intestinal  diges- 
tion, as  meats  are  a  food  for  gastric  digestion. 
They  act  as  antiseptics.  Combe  has  thrown 
much  light  on  this  subject  in  his  farinaceous 
regimens,  and  his  contentions  are  upheld  by  a 
number  of  authorities.  Physical  rather  than 
chemical  laws  are  very  likely  the  underlying 


CEREALS  171 

principles.  Carbohydrates  prevent  putrefaction ; 
hence  it  happens  that  in  the  lacto-farinaceous 
regimen  of  Combe  their  presence  retards  the  ab- 
sorption of  lactose  and  facilitates  the  production 
of  lactic  acid  all  along  the  intestinal  canal. 

Nutrition  is  influenced  in  a  parallel  sense  by 
the  carbohydrates  on  the  one  hand,  and  by  the 
lecithins  on  the  other,  both  being  elements  of 
economy,  since  they  restrain  notably  the  disas- 
similation  of  nitrogen.  The  stimulating  power 
of  the  cereals  is  very  limited,  as  they  give  off 
their  calories  gradually,  quite  in  proportion  to 
our  needs.  On  account  of  the  sugar  which 
makes  them  digestible,  they  are  suitable  for 
manual  labor  and  physical  exercise. 

The  action  on  the  kidneys  is  very  light,  be- 
cause there  is  so  little  of  albumin,  and  xanthic 
bases  are  absent;  and  also  because  the  ternary 
bodies  are  burned  up  in  the  water  and  carbonic 
acid.  Achard  and  Paisseau  have  demonstrated 
that  a  regimen  rich  in  carbohydrates  facilitates 
the  elimination  of  chlorids  and  diminishes  re- 
tention. 

There  are  certain  indications  and  contraindi- 
cations which  are  common  to  all  the  cereals  in 
general,  to  which  we  will  refer  now.  The  par- 


172  WHAT  SHALL   I   EAT? 

ticular  qualities  belonging  to  each  will  be  given 
in  separate  paragraphs. 

There  is  no  need  for  going  into  details  on  the 
question  of  food  value  for  the  normal  individ- 
ual, as  this  is  self-evident.  The  health  and 
physical  endurance  of  the  peoples  who  live  al- 
most exclusively,  or  at  any  rate  to  a  great  ex- 
tent, on  rice,  as  they  do  in  Asia,  or  on  maize,  as 
in  Italy,  or  on  oatmeal,  as  in  Ireland  and  Scot- 
land, bear  eloquent  testimony  to  their  quality 
of  being  an  ideal  food  for  all  who  are  engaged 
in  muscular  occupations.  Their  market  price  is 
reasonable,  and  the  demand  which  they  make 
on  the  action  of  the  stomach  is  slight. 

In  digestive  troubles  they  are  well  tolerated. 
Dyspeptics  can  well  support  them  so  long  as 
they  are  decorticated  and  served  in  an  appro- 
priate form.  Not  less  useful,  as  Combe  has 
proved  to  satisfaction,  are  they  found  in  intes- 
tinal troubles,  but  relaxing  or  constipating 
cereals  should  be  chosen  according  to  individ- 
ual propensities. 

These  same  digestive  qualities  and  the  ab- 
sence of  toxic  matter  point  to  them  also  in 
cardiac  and  in  Bright' 's  disease.  The  relative 
abundance  of  lecithin  and  phosphorus  render 


CEREALS  173 

them  worthy  of  consideration  as  a  food  for 
building  up  weakened  constitutions,  and  for  the 
period  of  growth  and  physical  development. 
Hence  they  are  suitable  for  convalescents  and 
consumptives — especially  the  varieties  that  are 
highly  mineralized. 

For  young  people  who  are  slow  in  developing 
(Springer),  nursing  women,  and  in  fevers  with 
demineralization,  cereals  that  are  rich  in  lecithin 
and  nuclein  should  be  freely  prescribed.  Dishes 
made  of  the  whole  grain  are  preferable. 

Martinet  gives  the  following  directions:  One 
table-spoonful  each  of  wheat,  rye,  oats,  barley, 
and  bran. 

Roast  slowly  in  the  oven  or  in  an  iron  dish; 
grind  in  a  coffee-mill  and  form  into  a  pulp  in  a 
mortar;  add  one  liter  of  water,  boil  down  to 
about  one-half  (at  least  two  hours  required); 
squeeze  through  a  bolting  cloth  and  add  enough 
water  to  make  one  liter  of  fluid.  Keep  in  a 
bottle  previously  rinsed  with  boiling  water.  It 
should  be  kept  in  a  cool  place,  or  in  the 
ice-box.  In  the  summer  months  it  should  be 
made  afresh  every  day;  in  the  winter  every 
other  day. 

For  children  the  use  of  cereals   is   common 


174  WHAT  SHALL   I    EAT? 

property.  We  will  refer  to  this  matter  again 
later  on  (page  226). 

Only  in  diabetes,  however,  are  serious  contra- 
indications observed.  Yet  there  are  no  abso- 
lute rules.  Von  Noorden  even  goes  so  far  as  to 
recommend  oatmeal.  The  tolerance  of  carbo- 
hydrates in  diabetics  is  a  complex  question. 
Recent  research  has  established  the  fact  that 
sugar  may  be  used  to  more  or  less  advantage, 
likewise  starch  and  the  plants  from  which  it  is 
derived. 

Labbe  has  proposed  a  classification  of  starches 
according  to  their  tolerance  by  diabetics.  The 
downward  scale  recommended  is  figured  out 
thus:  potatoes,  rice,  barley,  oats,  wheat,  vegeta- 
bles. But  there  is  nothing  definite  in  all  this. 
It  after  all  depends  on  personal  idiosyncrasies. 
Moreover,  the  tolerance  even  changes  almost 
every  moment  in  the  same  individual.  The 
question  can  only  be  decided  by  frequent  analy- 
sis of  the  urine,  which  gives  the  proper  indi- 
cations for  the  use  of  foods  applicable  to  the 
occasion. 


CEREALS  175 

SPECIAL  CHARACTERISTICS 

BARLEY 

Barley  is  rich  in  minerals  and  easy  of  diges- 
tion. The  percentage  of  phosphorus  is  only  ex- 
ceeded in  the  not  fatty  fishes,  the  yolk  of  the 
egg,  cheese,  cabbage,  spinach,  and  beans;  that 
of  magnesium  only  in  the  carrot.  Lime  is  very 
scant,  for  which  reason  it  agrees  with  patients 
suffering  from  oxaluria.  It  is  rather  laxative, 
on  account  of  the  large  content  of  cellulose. 

Barley  flour  is  used  for  infants,  by  convales- 
cents, and  tuberculous  and  demineralized  per- 
sons. It  is  also  claimed  to  be  of  exceptional 
value  in  the  diet  of  prize-fighters. 

Pearl-barley  is  less  nourishing  than  the  article 
hulled  by  machinery,  and  again  the  latter  less 
than  barley  decorticated  by  hand. 

Barley-water  has  ever  been  highly  prized  as  a 
beverage  for  fever  patients.  A  decoction  of  un- 
strained barley — or  a  full  tisane — formed  the 
meager  diet  (diseta  tenuis)  of  Hippocrates. 
When  strained,  however,  it  makes  the  rigidly 
meager  diet  (diaeta  exacte  tenuis). 

In  all  fevers  and  in  all  cases  in  which  the 
stomach  is  very  irritable — for  instance,  in  peri- 


176  WHAT  SHALL   I    EAT? 

tonitis,  dysentery,  typhoid- fever,  etc. — barley- 
water  is  the  drink  which  is  the  best  tolerated 
and  offers  the  most  advantages. 

Meunier  recommends  to  dyspeptics,  who  must 
take  their  beverages  hot,  an  infusion  of  sprouted 
barley  as  very  nutritious  and  easy  of  digestion, 
by  reason  of  the  diastase  which  it  establishes. 

OATS 

This  cereal  is  rich  in  fats  and  lecithins.  It 
is  rather  laxative,  but  at  the  same  time  stimu- 
lating. Porridge  is  a  common  dish  in  Ireland, 
Scotland,  England,  and  in  the  States.  It  is  an 
excellent  food  for  the  tuberculous  and  for  all 
persons  who  have  to  fight  against  emaciation. 

In  the  Orient  it  is  used  for  fattening  up  the 
young  girls  during  the  period  of  pubescence. 

Von  Noorden  makes  his  diabetic  patients  eat 
large  portions  of  oatmeal  well  mixed  with  but- 
ter and  vegetable  albumin.  The  tolerance  of 
carbohydrates  is  often  enhanced  thereby,  but 
the  results  are  by  no  means  always  the  same. 
Oat-water  is  made  in  the  same  manner  as  bar- 
ley-water, but  is  not  in  common  use  as  much  as 
the  .latter. 


CEREALS  177 

RICE 

No  other  foodstuff  is  of  the  same  superb  ser- 
vice to  the  human  race  as  rice.  It  forms  not 
only  the  predominant,  but  almost  the  exclusive 
nourishment  among  the  peoples  of  the  East. 
If  we  may  be  permitted  to  draw  a  lesson  of  die- 
tetic feeding  from  war,  we  may  at  once  claim 
that  the  Russo-Japanese  War  was  the  triumph 
of  rice  over  rye 

However,  it  is  not  wise  to  be  too  enthusiastic, 
as  there  are  also  drawbacks.  Rice  is  by  no 
means  a  complete  food;  it  is  too  rich  in  carbo- 
hydrates, and  too  poor  in  nitrogen  and  fats.  If 
we  were  to  meet  our  needs  for  nitrogen  by  the 
use  of  rice  alone,  the  quantity  required  would 
be  quite  excessive  and  far  beyond  the  physio- 
logical ration;  and  if  we  sought  to  find  the 
necessary  number  of  calories,  the  ration  would 
be  notoriously  deficient  in  nitrogen.  But  there 
are  no  people  who  content  themselves  with  the 
use  of  rice  alone;  meat  and  fish  are  also  con- 
sumed. The  Japanese  soldier  received  during 
the  war  each  day  500  grams  of  meat  or  about 
300  grams  of  salted  fish. 

Rice  is  the  poorest  in  albumin  of  all  the  cere- 


178  WHAT  SHALL   I    EAT? 

als.  Riibner,  in  his  experiments  with  adults, 
could  not  prevent  a  loss  of  a  minimum  of  90 
grams  per  diem,  which  was  the  equivalent  of 
the  rice  absorbed.  This  poverty  in  albumin  is 
one  of  the  reasons  why  rice  is  inferior  to  wheat. 
Rice — we  speak  here  of  the  shelled  article — con- 
tains only  about  half  the  amount  of  phosphorus 
and  lime  than  white  bread;  the  percentage  of 
magnesium  is  slightly  lower,  while  that  of  iron  is 
a  little  higher.  The  percentage  of  potassium  is 
six  times  higher  than  in  the  other  cereals.  That 
is  the  reason  why  the  races  that  live  on  rice  con- 
sume less  salt,  in  spite  of  the  fact  that  rice  con- 
tains only  small  traces  of  sodium  chlorid. 

Rice,  on  the  other  hand,  is  superior  to  bread 
in  its  content  of  cellulose,  which  struggles  with 
constipation  and  maintains  the  intestinal  tone 
so  closely  allied  to  the  tone  of  vitality.  But 
then  this  is  one  advantage  which  would  not 
affect  the  European  races,  were  they  inclined  to 
adopt  rice  as  their  only  staple  food.  Our  intes- 
tines, civilized,  badly  worn  and  badly  trained 
as  they  are,  would  not  know  how  to  master 
such  a  mass  of  residue. 

Nevertheless,  no  matter  what  the  relative 
values  of  bread  and  rice  are,  rice  is  an  excellent 


CEREALS  179 

food;  and  we  cannot  too  strongly  advise  its  use 
by  the  sick  as  well  as  the  healthy.  It  is  easy  to 
digest  and — a  very  valuable  quality — well  toler- 
ated in  hyperchlorhydria.  In  attacks  of  diar- 
rhea it  renders  excellent  service,  whether  it  be 
taken  whole  or  in  the  shape  of  rice-water — very 
likely  because  it  acts  rather  as  an  antiseptic 
than  a  binding  agent. 

If  consumed  in  large  quantities  it  may  fatigue 
the  digestive  apparatus  and  cause  constipation. 

Klemperer  recommends  it  in  cases  of  oxa- 
luria,  on  account  of  its  low  percentage  of  lime 
and  its  abundance  of  magnesium. 

The  form  in  which  it  is  easiest  digested  is 
when  boiled  to  a  point,  not  too  much  and  not 
too  little.  In  the  process  of  cooking  the  starch 
is  puffed  out  and  partly  converted  into  dextrin. 
The  alimentary  value  is,  of  course,  diminished 
proportionately.  One  hundred  grams  of  raw 
gives  about  300  grams  of  cooked  rice. 

When  boiled  in  water  with  some  kitchen  salt 
alone,  it  is  insipid  and  can  only  be  eaten 
in  small  quantities.  With  fat,  or  in  soup,  it 
appeals  more  to  the  palate.  But  cooked  with 
milk,  it  makes  one  of  the  best  of  culinary 
products,  because  the  deficiency  in  albumin 


180  WHAT  SHALL   I    EAT? 

and  fats  is  thus  thoroughly  compensated. 
Rice  pudding  offers  the  same  advantages;  it 
is  appetizing,  nutritious,  easy  to  digest,  and 
for  that  reason  useful  to  persons  with  a  capri- 
cious stomach. 

The  Orientals  eat  rice  without  the  addition  of 
other  foodstuffs,  but  they  know  how  to  season 
the  taste  with  a  variety  of  spices. 

MAIZE — CORN 

This  is  the  wheat  of  the  people  living  in  the 
southeastern  section  of  France,  in  the  northern 
parts  of  Italy,  in  the  Tyrol,  in  Roumania,  and 
in  certain  sections  of  Hungary.  [It  is  used 
largely  in  the  United  States  as  sweet  or  sugar 
corn,  and,  especially  in  the  Southern  States, 
for  making  corn-bread  and  corn-cakes.  Under 
the  name  of  hominy  it  is  well  known  as  a 
breakfast-food.  In  Italy  "polenta"  is  eaten 
with  grated  cheese.  —  Translator.] 

Maize  is  rich  in  fats  and  cellulose,  but  poor 
in  albumin.  It  is  a  very  nutritious  food;  but, 
unless  eaten  fresh  from  the  cob,  demands  a 
robust  stomach. 

Mineral  substances,  with  the  exception  of 
magnesium,  are  absent. 


CEREALS  181 

[Pellagra,  a  disease  endemic  among  the 
maize-eating  races,  running  parallel,  it  seems, 
with  beri-beri  among  the  rice-eating  nations, 
has  recently  been  made  the  subject  of  research 
by  many  medical  authorities.  As  in  beri-beri, 
its  causes  and  origin  are  as  yet  but  imperfectly 
understood,  for  which  reason  remedial  and  pre- 
ventive measures  are  still  lacking.  The  gov- 
ernments of  several  countries  are  now,  however, 
taking  an  active  interest  in  this  important 
question,  and  satisfactory  results  may  soon  be 
expected.  —  Translator.]  The  bran  of  maize 
appears  to  be  strongly  impregnated  with  toxic 
matter,  which  accounts  for  the  fact  that  corn- 
meal  is  less  dangerous.  Balf  recommends  that 
corn-flour,  used  for  consumptives,  should  be 
quite  fresh,  as  the  toxins  develop  rapidly  with 
the  age  of  the  flour. 

RYE 

The  black  bread  made  from  it  is  eaten  chiefly 
by  the  inhabitants  of  poorer  districts.  Lime, 
iron,  and  cellulose  are  its  characteristic  ele- 
ments, all  of  which  should  prove  valuable  in 
the  treatment  of  constipation.  The  bolted 
flour  makes  the  ordinary  rye-bread.  When 


182  WHAT  SHALL   I    EAT? 

unbolted,  the  product  is  called  "pumpernickel" 
by  the  Germans.  Both  kinds  are  hard  to  di- 
gest, and  from  this  point  of  view  inferior  to  the 
white  bread  which  is  made  from  wheat. 

Rye  is  often  tainted  by  a  parasite,  the  clavi- 
ceps  purpurea,  or  ergot,  of  rye.  This  is  a 
poisonous  substance  and  often  gives  rise  to 
epidemics,  the  symptoms  of  which  strongly 
resemble  those  of  ergotin-poisoning,  and  are 
strongly  marked  by  gangrene  of  the  extrem- 
ities. 

BUCKWHEAT 

This  is  also  called  "black  wheat"  in  Nor- 
mandy and  the  Bretagne,  where  it  is  exten- 
sively cultivated  and  baked  into  cakes  known 
as  ' '  galettes, ' '  which  keep  for  a  long  time.  It 
is  a  heavy  food  and  hard  to  digest.  [Buck- 
wheat cakes  are  a  favorite  breakfast  dish  in 
the  United  States.  —  Translator.  ] 

WHEAT 

We  have  reserved  this  to  the  last  on  account 
of  its  special  dietetic  importance.  Its  food 
value  is  only  second  to  that  of  oats.  Unfortu- 
nately it  is  not  so  rich  in  mineral  substances. 


CEREALS  183 

The  flour  made  from  wheat  is  hardly  ever 
used  by  itself  as  a  food.  But  the  products  into 
which  it  enters,  such  as  bread,  biscuits,  pastry, 
pastes,  etc.,  are  of  vital  interest  to  every- 
body. 


BREAD 

To  the  white  races  bread  is  the  staff  of  life, 
the  staple  food  indispensable  for  their  daily 
rations.  It  represents  at  least  two-thirds  of 
the  alimentation  of  the  poorer  classes.  When  a 
foodstuff  like  bread  has  once  assumed  such  an 
important  position  in  the  diet  of  nations,  the 
slightest  modification  which  it  undergoes  will 
have  a  very  intimate  effect,  either  good  or 
evil,  on  the  public  health  and  welfare  of  the 
community. 

The  manufacture  of  flour,  as  well  as  that  of 
bread,  has,  during  the  past  century,  undergone 
many  improvements;  but  whether  they  offer 
ground  for  approval  or  regret  remains  to  be  seen. 

In  days  gone  by,  the  flour  used  for  making 
bread  was  ground  between  millstones,  but  in 
modern  times  metal  cylinders  are  employed 
which  crush  the  very  heart  out  of  the  grain. 
The  sifting  and  bolting  of  the  flour  consist  in 
the  removal  of  the  husk  or  skin  of  the  grain, 
which  is  called  bran,  and  gives  the  flour  a  dark 

184 


BREAD  185 

or  blackish  appearance.  A  10  per  cent  bolting 
still  leaves  a  goodly  amount  of  this  impurity  in 
the  flour.  The  best  white  varieties  are  subject 
to  30  per  cent  of  bolting. 

To  make  home-made  bread,  flour  is  mixed 
with  water  and  a  small  amount  of  kitchen  salt, 
to  which  is  added  a  proportionate  amount  of 
yeast  or  leaven.  This  mixture  is  allowed  to 
stand,  generally  overnight,  and  to  rise.  In 
the  morning  the  dough  is  kneaded,  formed  into 
loaves,  and  then  baked  in  the  oven,  where  it 
assumes  its  characteristic  golden  yellow  appear- 
ance. 

The  product  represents  about  100  per  cent, 
i.e.,  100  pounds  of  flour  will  make  about  100 
pounds  of  bread. 

COMPOSITION   AND   ALIMENTARY   VALUE 

Albumin 6.94 

Fats 0.95— Chlorid.  .  .    0.65 

Carbohydrates  .    52.69— Purins O.OO1 

Ash 0.79 

Available  calories  =  255 

These  figures  refer  to  bread  of  medium  white- 
ness. Nitrogen  is  formed  of  the  gluten  or 

1  Whole-meal  bread  contains  about  0.04  per  cent. 


186  WHAT   SHALL   I   EAT? 

gluten  casein,  a  true  vegetable  casein  which 
swells  in  water.  It  is  accompanied  by  cerealin, 
a  vegetable  pepsin,  which  possesses  the  property 
of  peptonizing  the  nitrogenous  matter.  The 
fats  consist  chiefly  of  phosphorated  lecithin. 
Nearly  the  whole  of  the  phosphoric  content 
exists  in  this  form,  if  not  in  the  form  of  diphos- 
phoric  methylic  acid. 

Starch  is  the  essential  and  truly  nutritive 
element  of  bread.  The  percentage  varies  con- 
siderably, but  oscillates  between  40  and  60, 
and  is  dependent  on  the  manner  of  making 
the  bread.  In  the  beginning  it  undergoes, 
partially  at  least,  carbonic  fermentation.  The 
gas  permeates  the  dough  and  makes  it  light. 
During  the  baking  the  starch  of  the  crumb 
is  transformed  into  starchy  paste,  and  fixed 
or  united  with  the  gluten.  In  the  skin  of 
the  crust  the  heat  of  the  oven  produces  an 
ample  amount  of  dextrin  with  partial  cara- 
melization. 

Among  the  mineral  constituents  phosphorus 
prevails,  chiefly  in  the  organic  form.  Potas- 
sium and  magnesium  are  well  represented. 
The  ash  is  acid,  by  reason  of  the  predominance 
of  phosphoric  acid. 


BREAD  187 

Since  bread  is  nearly  wholly  absorbed  by 
the  economy,  its  nutritive  value  is  high;  it 
ranks  after  the  legumes  (peas,  lentils)  and 
cheese,  but  precedes  meat  and  potatoes.  The 
alimentary  value  of  the  crust  is  sensibly  higher 
than  that  of  the  crumb,  because  it  contains  less 
water  (25  per  cent  as  against  45  per  cent  in  the 
latter).  That  is  the  reason  why  it  is  better  to 
make  loaves  oblong,  for  they  represent  a  larger 
amount  of  crust.  A  round  loaf  of  bread, 
weighing  one  pound,  contains  39  per  cent  of 
water;  but  a  long  loaf,  weighing  a  pound  and 
a  half,  only  33  per  cent.  Stale  bread  is  also  a 
little  less  hydrated,  although  its  peculiar  quali- 
ties do  not  depend  on  this  condition,  because, 
when  warmed  up,  it  resumes  almost  entirely  the 
characteristics  of  newly  made,  fresh  bread,  in 
spite  of  the  fact  that  the  reheating  process  still 
further  assists  in  the  evaporation  of  water. 

When  bread  is  eaten  together  with  other  ar- 
ticles of  food  its  alimentary  powers  are  consid- 
erably increased.  We  wish  to  emphasize  here, 
however,  that  among  the  numerous  devices  em- 
ployed in  the  household,  there  are  only  two 
which  appeal  to  us  as  particularly  judicious, 
the  first  is  the  spreading  of  butter  on  the 


188  WHAT  SHALL   I    EAT? 

bread,  because  in  this  wise  the  necessary  amount 
of  fat  is  added;  and  secondly,  the  use  of  cheese 
with  bread,  which  raises  the  standard  of  both 
the  fats  and  nitrogen  very  appreciably. 

REACTIONS 

a.  Digestive. — The  action  of  bread  on  the 
stomach  is  rather  complex.  To  be  properly  un- 
derstood, it  must  be  considered  by  itself.  Glu- 
ten, like  all  vegetable  albumins,  is  hard  to 
digest,  and  provokes  a  very  strong  peptic  secre- 
tion, four  times  as  strong  as  that  of  milk  or 
meat.  —  (Chigin.)  But  it  is  small  in  quantity, 
while  the  starch,  which  is  the  predominant  fac- 
tor, escapes  the  action  of  the  gastric  juices  and 
comes  under  the  influence  of  ptyalin;  that  is 
to  say,  on  the  condition  that  the  rate  of  hydro- 
chloric acid  present  is  low. 

The  constituents  of  bread  are  changed  but 
little  in  the  stomach,  if  the  physical  conditions 
in  which  it  enters  do  not  paralyze  the  action 
of  the  salivary  ferments  and  pep  tonic  juices. 
When  taken  in  overlarge  quantities,  or  when 
it  is  insufficiently  chewed  and  masticated,  it 
forms  a  compact  spongy  mass,  difficult  to  break 
up,  and  which  quickly  ferments.  This  explains 


BREAD  189 

the  fact  that  dyspeptic  persons  often  cannot 
tolerate  it,  and  that  it  is  prone  to  aggravate  di- 
gestive troubles.  To  prevent  both  these  patho- 
logical conditions,  it  is  quite  sufficient  to  turn 
the  bread  into  pulled  bread  or  into  dry  toast. 

In  the  intestines  the  process  of  digestion  is 
accelerated,  and  it  reaches  there  its  final  stage. 
Fortunately,  the  percentage  of  nitrogen  is  low. 
Among  the  albumins,  gluten  requires  the  largest 
amount  of  tryptic  ferment.  It  is  different  with 
the  hydrocarbonic  element.  The  starch  of  the 
bread  yields  to  the  amylolytic  secretion  in  its 
weakest  form. 

The  absorption  of  albumin  by  the  bowels 
reaches  only  79  per  cent,  while  that  of  the 
starch  goes  up  to  as  high  as  99  per  cent.  On 
the  whole,  bread  leaves  but  little  residue,  and 
that  is  the  reason  why  it  is  claimed  by  many  to 
favor  constipation. 

In  a  previous  chapter  (page  110)  we  have  seen 
that  the  percentage  of  nitrogen  being  equal, 
the  effort  required  to  digest  bread  by  far  ex- 
ceeds that  of  milk;  but  this  can  have  reference 
only  to  the  nitrogenous  content.  When  we 
take  the  amylolytic  ferments  into  consideration, 
we  find  that  the  starch,  which  is,  after  all,  the 


190  WHAT  SHALL   I   EAT? 

real  nutrient  element  of  bread,  is  digested  at 
very  small  expense  of  physical  force.  This 
brings  us  to  the  conclusion  that  bread,  al- 
though a  good  purveyor  of  carbohydrates,  is  a 
poor  provider  of  nitrogen. 

b.  General. — Short    of    nuclein    as   well    as 
nitrogen,  bread  exerts  only  a  small,  albeit  be- 
nign, stimulating  power  over  nutrition  in  gen- 
eral and  the  organism  in  particular;  powerful 
as  an  element,  it  gives  off  its  calories  only  in 
proportion  to  our  needs,  without  provoking  an 
artificial  stimulation,  which  would  in  any  case 
be  followed  by  a  wave  of  depression. 

For  all  that,  it  is  acidiferous.  Gautier  has 
made  this  clear  by  proving  the  predominance  of 
phosphoric  acid  in  the  ash. 

c.  Eliminatory. — Unless    it  ferments  within 
the  tube,   bread  leaves  but  small  traces  of  ex- 
cretion behind,  consisting  chiefly  of  water  and 
carbonic  acid.     If  properly  digested,  it  imposes 
only  a  very  light  task  upon  the  kidneys. 


BREAD  191 

INDICATIONS   AND   CONTRAINDICATIONS 

Bread  is  for  all,  hale  or  ailing,  the  funda- 
mental element  of  alimentation.  From  the 
physiological  standpoint  the  man  who  performs 
manual  labor  requires  a  large  quantity  of  it. 
So  far  as  pathological  conditions  are  concerned, 
we  know  of  no  disease  in  which  the  use  of  bread 
is  especially  indicated;  but  there  are  such  in 
which,  by  retaliation,  as  it  were,  it  is  badly  tol- 
erated and  may  even  prove  harmful. 

Of  course,  the  first  place  is  claimed  here  by 
the  gastric  affections.  Nowadays  a  number  of 
stomachs  have  forgotten  how  to  digest  bread. 
Surcharging  the  canal  with  bread  produces 
putrefaction,  and  lays  the  foundation  for  the 
numerous  cases  of  dyspepsia  in  heavy  eaters  and 
in  individuals  who  force  the  food  down  in  a 
hurry,  swallowing  it  without  proper  mastica- 
tion. Frequently  it  is  quite  sufficient  to  cut 
down  the  daily  ration  of  bread  and  allow  it 
only  in  the  shape  of  toast,  to  see  most  of  the 
symptoms  vanish  as  if  by  magic. 

In  hyperchlorhydria  it  is  borne  with  small 
success;  for  the  salivary  ferments  are  clogged 
in  the  superacidity  of  the  gastric  juices,  and  the 


192  WHAT  SHALL   I    EAT? 

starch,  remaining  undigested,  quickly  under- 
goes putrefaction.  All  starchy  foods — and 
bread  belongs  to  them — should  be  permitted 
in  small  quantities  only.  The  same  must  be 
observed  in  dilatation  and  in  stenosis.  In  other 
forms  the  idiosyncrasy  of  each  patient  should 
be  the  guiding  line. 

As  a  general  rule  fresh  bread  is  harder  to 
digest  than  the  stale  and  seasoned  article,  as  it 
offers  a  more  stubborn  resistance  to  the  attacks 
of  the  gastric  juices.  This  refers  to  hot  bread 
even  with  stronger  force.  In  like  manner  the 
crust  is  easier  to  digest  than  the  crumb,  as  we 
have  already  pointed  out.  The  physician  will 
know  when  to  recommend  toast,  or  crackers, 
or  * '  zwieback. ' ' 

For  intestinal  affections  a  great  deal  of  cau- 
tion is  needed,  and  it  is  often  advisable  to  lay 
down  strict  rules,  especially  in  cases  of  constipa- 
tion. 

Diabetics  should  scratch  bread  almost  entirely 
from  their  menu.  But  to  overcome  this  hard- 
ship, which  may  seriously  impair  the  appetite, 
bread  deprived  of  its  carbohydrates  and  en- 
riched with  albumin  may  be  easily  obtained  in 
the  market.  Among  the  most  serviceable  we 


BREAD  193 

may  mention  " gluten  bread,"  which  contains 
only  from  10  to  30  per  cent  of  carbohydrates, 
and  also  "almond  bread." 

In  arthritis  the  daily  ration  must  be  strictly 
limited,  so  much  the  more  as  the  patients  fre- 
quently have  a  great  liking  for  bread. 

For  overfeeding,  bread  is  an  important  factor, 
but  all  the  same  it  is  a  source  of  stasis,  intestinal 
putrefaction,  and  humoral  acidity.  An  average 
allowance  of  250  grams  (half  a  pound)  per  day 
should  be  ample;  the  rest  of  the  diet  might 
be  supplemented  with  potatoes  boiled  in  water, 
which  have  the  advantage  of  being  [less  nutri- 
tious, slightly  laxative,  and  alkalin  withal.  In 
gout  a  similar  diet  is  counseled. 


194  WHAT  SHALL   I    EAT? 


VALUE  OF  WHITE  BREAD 

So  far  we  have  spoken  of  the  ordinary  white 
bread  made  of  the  best  and  finest  wheat  flour, 
such  as  may  be  found  everywhere  nowadays  in 
cities  as  well  as  in  the  country.  We  will  now 
consider  in  how  far  and  under  what  conditions 
it  is  a  superior  food  to  the  coarse  bread  made  in 
former  days. 

The  difference  in  its  manufacture  is  twofold: 
1.  The  flour  is  ground  between  steel  cylin- 
ders instead  of  stone;  2,  a  more  careful  sifting 
makes  it  whiter.  The  result  of  these  two  ma- 
nipulations is  a  more  thorough  expulsion  of  the 
bran,  and  therefore  a  finer  quality  of  flour.  If 
we  are  to  speak  of  the  effect  this  has  on  the 
calories  alone,  we  shall  find  it  very  favorable. 
If  the  content  of  nitrogen  is  somewhat  reduced 
by  this  method,  starch  in  the  bread  is  increased 
and  intestinal  absorption  is  facilitated.  In  the 
white  bread  the  power  of  absorption  rises  to 
95  per  cent;  while  in  the  cruder  forms  made  of 
the  whole  grain,  it  is  only  90  per  cent.  So  far 
as  appearance  is  concerned,  this  is  a  matter 
of  secondary  consideration.  But  it  is  necessary 


BREAD  195: 

to  increase  the  average  of  the  daily  ration  by 
5  per  cent,  in  order  to  compensate  for  the 
losses.  Yet  from  another  rather  problemati- 
cal standpoint,  the  white  bread  has  two  decided 
disadvantages. 

1.  It  is  not  sufficiently  stimulating,  primarily, 
to  the  digestive  tube.  The  residue,  however, 
that  is  the  cellulose  contained  in  the  bran 
which  has  been  dreaded  so  much  and  by  so 
many,  nevertheless  possesses  most  useful  qual- 
ities, if  present  in  small  quantities  only,  for  it 
sustains  the  tone  of  the  digestive  tube,  raises 
the  power  of  functioning,  and  strives  against 
atony  and  constipation.  In  our  days  it  is  the 
digestive  tube  of  all  organs  which  shows  the 
most  marked  degree  of  degeneration.  Consti- 
pation, cecal  stasis,  and  all  the  evil  conse- 
quences, enterocolitis,  appendicitis,  and  prema- 
ture senility,  are  they  not  all  partially,  at  least, 
due  to  this  regrettable  use  of  flour  so  quickly 
assimilated,  and  leaving  no  ash  ?  Many  au- 
thorities have  answered  this  question  latterly 
in  the  affirmative. 

The  white  bread  is  not  sufficiently  stimula- 
ting to  the  general  organism.  This  contention 
will  be  clear  to  him  who  understands  the  inti- 


196  WHAT  SHALL   I    EAT? 

mate  relationship  that  exists   between   the  di- 
gestive and  the  general  tone.     If,  on  the  other 
hand,   the   general    organism    has   to  fear   evil 
results  from  the  atrocious  and  coarse  overstim- 
ulation    caused  by  certain   foods,   then  it  can- 
not either,  on  the  other  hand,  be  satisfied  with 
the  normal  tonic  furnished  by  alimentation  in 
general.     Cellular  life  is  a  function  due  to  ex- 
citation;   a  diminution  in  the  latter  is  bound 
to  lessen  the  intensity  of  the  former.     This  in- 
sufficiency of  stimulating  power  is  particularly 
serious  in  a  food  which  represents  two-thirds  of 
our  daily  needs  and  constitutes   the  source  of 
an  energy  so  minutely  graduated  and  so  well 
regulated.     We  need    not   be   amazed   if,  with 
the  introduction  of  white  bread  in  the  country 
districts,  the  peasant,  finding  no  longer  the  re- 
quired quotum  of  stimulation  in  the  bread,  goes 
to  seek  it  elsewhere.  —  (Monteuuis.}1    And  here 
it  is  where  the  bread  question  touches  the  ques- 
tion of  alcohol. 

The  second  defect  in  the  white  bread  is,  that 
it  is  not  sufficiently  mineralized  and  is  insuffi- 
ciently phosphorated.  This  fault,  of  grave 

'Monteuuis:  "L'alimentation  et  la  cuisine  naturelle  dans 
le  monde." 


BREAD  197 

import  for  this  as  well  as  for  all  other  ali- 
ments, represents  a  deficiency  of  about  20  per 
cent  of  mineral  matter  in  our  ration,  as  has 
been  amply  demonstrated  by  chemical  analysis. 
We  quote  from  Muntz  the  following  table 
showing  the  comparative  composition  of  flour 
ground  on  metal  and  flour  ground  on  stone. 

Ground  on  Metal.  Ground  on  Stone. 

Crust.  Crumb.  Crust  Crumb. 

Nitrogenous  matter.  ..    8.06          5.87          8.50          6.62 

Ash 1.81          1.57         2.52         2.06 

Phosphoric  acid 0.19          0.13          0.28          0.20 

The  sifting  and  bolting  accentuate  still  more 
the  damage  already  done.  Of  21  parts  of  min- 
eral salts  contained  in  1,000  parts  of  grain,  only 
5.5  are  in  the  flour,  while  15.5  are  in  the  bran; 
and  of  8. 93  parts  of  phosphorus,  2. 33  are  in  the 
flour,  and  6.60  in  the  bran.  The  bran,  there- 
fore, which  we  so  ingeniously  separate  from  the 
flour  to  the  highest  potentiality,  carries  off  with 
it  three-fourths  of  the  mineral  constituents  of 
the  grain,  i.  e. ,  phosphorus,  magnesium,  etc. 

But  it  can  serve  no  good  purpose  to  dwell 
any  longer  on  the  importance  of  these  facts. 
An  organism  impoverished  in  mineral  sub- 
stances, a  nervous  system  robbed  of  its  per- 


198  WHAT  SHALL   I    EAT? 

centage  of  phosphorus  and  magnesium,  must  of 
necessity  be  vitiated  and  impaired.  We  cannot 
help  but  admit  that  this  deterioration  of  bread 
logically  crops  from  the  customs  of  our  times 
and  from  the  intensity  of  our  present-day  life. 
In  the  same  measure  our  nervous  and  cerebral 
underfeeding  intensifies  the  phosphoric  disas- 
similation;  and  demineralization  is  on  the  daily 
increase. 

Many  efforts  have  already  been  made  to 
remedy  these  evils,  which  are  the  natural  con- 
sequences of  our  industrial  progress. 

We  have  already  discussed  the  drawback  to 
be  found  in  white  bread,  so  far  as  the  bowels 
are  concerned.  To  counteract  constipation  cer- 
tain kinds  of  bread  have  been  recommended 
which  leave  a  sufficient  percentage  of  residue; 
among  them  rye-bread,  also  called  brown  bread 
or  black  bread,  likewise  Graham  bread,  which 
is  made  with  all  the  elements  of  the  whole  grain 
coarsely  ground.  All  these  are  serviceable,  but, 
after  all,  only  to  heavy  eaters  with  a  robust  di- 
gestion. Most  of  the  modern  stomachs,  how- 
ever, are  too  delicate  to  digest  them. 

The  more  and  the  better  this  question  is 
studied  and  ventilated,  the  clearer  becomes  the 


BREAD  199 

object  to  be  attained,  and  the  greater  will  be 
the  efforts  to  produce  an  ideal,  rational  bread 
which  will  possess  all  the  required  good  quali- 
ties. Two  formulas  have  been  suggested:  one 
faction  recommends  the  true  whole-bread  con- 
taining the  whole  of  the  grain;  another  faction 
wants  the  brown  bread,  called  also  "modern" 
brown  bread  (Monteuuis),  which  ranks  half 
way  between  the  white  bread  and  the  whole- 
meal bread.  We  freely  give  our  approval  to 
the  latter  form.  The  only  strong  objection  to 
the  whole-meal  bread  is  the  difficulty  of  di- 
gesting and  tolerating  it.  Our  economy  no 
longer  seems  strong  enough  to  support  a  food 
relatively  coarse.  With  the  brown  bread  the 
inconvenience  is  minimized.  Moreover,  it  is 
advisable  to  proceed  slowly  in  this  reform  by 
taking,  for  instance,  in  the  beginning,  50,  then 
100,  then  200  grams,  and  so  on,  until  the  full 
amount  can  be  consumed  with  impunity.  The 
advantages  of  mineralization  seem  to  equalize 
themselves  after  a  short  time.  Fauvel  l  substi- 
tutes for  white  bread  one  equal  part  of  whole- 
meal bread  and  one  equal  part  of  modern 


:  Congres  international  d'hygiene  alimentaire.  Paris, 
1906. 


200  WHAT   SHALL   I    EAT? 

brown  bread,  and  claims  that  in  two  cases 
under  observation  the  increase  in  phosphoric 
excretion  was  about  0.25  gram.  A  daily  gain 
of  0.25  gram  would  mean  for  the  year  a  total 
of  91.25  grams  of  phosphoric  acid. 

We  need  scarcely  come  back  again  to  the 
special  varieties  of  bread  which  are  sold  at  more 
or  less  advanced  prices  to  the  public.  After 
all,  it  is,  perhaps,  easy  enough  to  obtain  at  the 
baker-shop  bread  made  from  any  grade  of  flour. 
The  question  is  not  without  difficulty,  how- 
ever, and  possesses  interest  enough  to  justify 
continued  efforts  in  the  right  direction. 

BISCUITS— CRACKERS 

They  owe  their  name  and  properties  to  the 
manner  of  their  manufacture,  i.  e. ,  a  paste  con- 
sisting of  wheatmeal  and  water  twice  baked. 
They  are  easy  to  digest  and  very  nutritious. 
Many  contain  also  milk,  butter,  and  eggs  in 
variable  proportions.  The  average  composition 
of  dry  biscuits  is: 

Available 
Albumin.  Fat.  Carbohydrates.  Ash.  Calories. 

8.99  7.92  69.74  1.34  399 

A  glance  will   reveal  their  value,  as  an  article 


BREAD  201 

of  food  and   the   high   percentage  of   mineral 
content. 

As  they  are  very  easy  to  digest,  and  not  sub- 
ject to  putrefaction,  they  are  suitable  for  diges- 
tive troubles.  In  intestinal  dyspepsia,  in  all 
gastric,  cardiac,  and  liver  complaints,  in  Bright' s 
disease,  and  in  anorexia,  they  should  replace 
bread  to  advantage,  and  allow  of  happy  changes 
in  a  diet  otherwise  insufficient.  In  the  milk  diet 
they  are  indispensable  for  correcting  insipidity 
and  desirable  proportions.  We  take  exception, 
however,  to  all  kinds  of  biscuits  or  crackers 
that  are  lined,  coated,  or  stuffed  with  creamy 
or  jammy  substances,  for  they  are  hard  to  digest 
and  belong  rather  to  the  category  of  pastry. 

PASTRY 

An  enormous  variety  of  articles,  all  dissimilar 
in  composition,  quality,  and  food  value,  belong 
to  this  denomination.  Nevertheless,  since  paste 
is  the  principal  ingredient — and  all  its  injurious 
qualities  are  common  to  most  of  them — we  have 
thought  it  reasonable  to  speak  of  it  here  under 
the  head  of  wheat  flour. 

Butter  and   eggs   are   employed   in   varying 


202  WHAT  SHALL   I    EAT? 

proportions,  and  the  whole  is  carefully  mixed, 
rolled,  and  cooked  in  a  slow  oven.  The  product 
is  of  a  solid  consistence,  very  nutritious,  but 
difficult  to  digest,  especially  when  not  suffi- 
ciently baked.  The  puffs  are  perhaps  a  little 
lighter,  but  frequently  bear  the  disadvantage  of 
being  made  of  stale  cake. 

Paste  is  only  the  foundation  of  this  unhealthy 
and  antihygienic  food.  The  multitude  of  re- 
cipes and  formulas  is  the  sum  total  of  all  the 
mischief  wrought  by  their  use,  no  matter  under 
what  name  they  are  advertised  and  sold;  petits 
fours,  fondants,  dragees,  pralines,  fritters,  pan- 
cakes, they  all  belong  to  the  long  list  of  dan- 
gerous, mischievous  preparations  called  pastry. 
Their  bad  qualities  belong  to  the  digestive  or- 
der. They  surcharge  and  fatigue  the  stomach 
and  invite  intestinal  putrefaction. 

The  whole  catalogue  of  cakes,  sweetmeats, 
cookies,  and  pastry,  without  exception,  must  be 
forbidden  in  dyspepsia,  enter  ocolitis,  diarrhea,  and 
constipation;  in  cardiac  and  in  Bright' s  disease, 
in  eczema,  and  in  all  skin  diseases;  likewise  in 
diabetes,  liver  troubles,  obesity,  and  arthritis. 
The  hale  and  hardy  are  cautioned  to  use  dis- 
cretion. The  gentle  sex  particularly  is  prone 


BREAD  203 

to  commit  indiscretions  in  this  direction,  a  fact 
which  accounts  for  the  many  crises  in  dyspepsia, 
anemia,  and  diabetes  among  women. 

But  there  is  a  kind  of  home-made  pastry 
which  may  grace  any  table  and  even  prove  of 
benefit  to  the  sick,  as  it  is  light  and  easy  to 
digest,  pleases  the  palate,  and  possesses  none 
of  the  offensive  qualities  mentioned  above — dia- 
betes, however,  always  excluded. 

It  embraces,  according  to  Pascault — setting 
aside  the  biscuits  already  mentioned — the  fol- 
lowing: 

Cakes  made  of  sweetened  paste  (flour,  sugar, 
eggs,  and  butter),  known  as  madeleines,  Genoa 
and  Savoy  cakes. 

Gingerbread  and  ginger-snaps. 

Tarts  made  with  fruit  or  rice,  but  always 
presupposing  that  the  crust  of  the  paste  be 
baked  crisp. 

Meringues  made  with  whipped  cream,  but 
not  with  cream  bought  of  the  pastry  cook. 

We  may  add  brioche,  especially  flannel 
brioche,  which,  if  thoroughly  done  and  eaten 
with  butter,  is,  as  a  rule,  tolerated  even  by 
dyspeptics. 


204  WHAT  SHALL   I    EAT? 

NUTRITIOUS   PASTES 

These  are  obtained  by  mixing  wheat  flour 
with  variable,  but  always  small,  quantities  of 
milk,  butter,  and  eggs;  macaroni,  vermicelli, 
noodles,  tapioca,  Italian  paste.  All  these  are 
as  near  as  possible  identical  in  composition. 

We  give  only  the  analysis  of  macaroni. 

Albumin 10.46 

Fats 0.70— Chlorid  .  .    0.08 

Carbohydrates  .  72.34 — Purin  ...   0.00 

Ash 0.83 

Available  calories  =  349 

Although  the  proportion  of  the  constituents 
approaches  that  of  the  cereals,  especially  that 
of  bread,  the  food  value  is  lower,  for  the  ash 
is  alkaline,  and  the  percentage  of  phosphate  of 
soda  is  too  high. 

However,  they  are  light,  especially  for  intes- 
tinal digestion. 

Combe  recommends  them  strongly  in  his 
regimen  for  gastric  and  intestinal  dyspepsia. 
They  serve  as  a  substitute  for  bread  in  gastric 
dilatation  with  fermentation,  and  in  enter ocolitis. 

To   be   truly  efficacious  they  should  be  pre- 


BREAD  205 

pared  without  butter  and  cheese;  simply  boiled 
in  slightly  salted  water.  When  placed  on  the 
table,  a  small  dab  of  butter  and  some  grated 
cheese  may  be  added  to  make  them  more 
palatable.  According  to  Combe  they  are  more 
digestible  if  no  eggs  are  used. 

Contraindications  are  diabetes  and  obesity. 
They  agree  with  all  whose  bowels  function 
badly,  i.e.,  in  liver  complaints,  cardiac  affec- 
tions, Bright3 s  disease,  and  often  in  arthritis, 
but  their  use  must  be  properly  gaged. 

In  dyspeptic  tuberculosis,  rapid  and  lasting 
fattening  is  often  achieved  with  a  generous  diet 
of  these  preparations. 


206  WHAT  SHALL   I    EAT? 

CHESTNUTS 

In  many  parts  of  the  world  the  large  and  the 
small  varieties  of  chestnuts  play  an  important 
role  in  the  diet  of  the  inhabitants.  In  Corsica, 
they  are  called  "the  bread  of  the  tree."  Al- 
though they  do  not  belong  to  the  same  family, 
they  approach  the  cereals  very  closely  in  com- 
position. 

Albumin 6.35 

Fats 2.40 

Carbohydrates 67.00 

Ash 1.60 

Available  calories  =  321 

The  percentage  of  nitrogen  and  carbohy- 
drates is  lower  than  in  the  flour  of  wheat,  but 
that  of  the  fats  exceeds  it.  Mineral  bodies  are 
plentiful. 

The  pulp,  however,  made  from  cooked  or 
boiled  chestnuts,  and  chestnut  flour  are  not 
so  light,  and  should  not  be  eaten  by  dyspeptics. 
As  a  nourishment  to  the  normal  constitution 
they  possess  real  value. 


LEGUMES-PULSE 

THESE  form  a  group  remarkably  homoge- 
neous, so  far  as  good  and  bad  qualities  as  well 
as  composition  are  concerned.  The  composition 
is  almost  identical  in  all  of  them. 

COMPOSITION   AND   FOOD   VALUE 

Car  bo- 
Albumin.  Fats,  hydrates.   Ash.  Purins.  Chlorid.  Calories. 

Lentils 20.40  1.31  57.40  2.35  0.07  0.07  337.40 

White  beans 17.45  1.39  59.69  2.63  0.07  0.02  334.50 

Split  peas 19.35  1.54  57.71  2.10  0.04  0.05  336.00 

Dried  broad  beans  21.01  1.45  55.25  2.22  0.00  0.04  332.00 

The  content  of  nitrogen  in  legumes  equals 
that  of  meat,  but  in  carbohydrates  they  are 
superior. 

The  nitrogen  in  pulse  is  called  legumin,  i.e., 
a  vegetable  casein,  which  forms  with  water  a 
paste  that  is  analogous  to  gluten,  but  is  easier 
to  digest. 

The  legumes  are  rich  in  nuclein — the  richer, 
the  younger  the  growth.  They  must  be  classed 
among  the  foods  that  produce  uric  acid,  for 
instance,  meat. 

207 


208  WHAT  SHALL   I    EAT? 

Oxalic  acid  is  found  in  notable  quantities  in 
white  and  broad  beans;  lentils  and  peas  are  free 
from  it. 

If  fats  are  absent,  the  carbohydrates  abound 
in  the  form  of  starch  in  about  the  same 
measure  as  in  the  flour  of  cereals,  but  the  per- 
centage of  cellulose  is  sensibly  higher,  though 
principally  localized  in  the  skin,  or  husk,  of 
the  seed.  This,  of  course,  enhances  the  food 
value  of  decorticated  pulse.  The  ash  contrib- 
utes a  large  part  of  this  high  dietetic  value,  as 
its  percentage  is  twice  that  of  meat  or  bread. 
The  young,  green  legumes  are  mineralized  in 
a  higher  degree  with  a  corresponding  elevation 
of  calories.  Potash  is  preponderant,  and  when 
combined  with  soda — present  in  a  lesser  de- 
gree— it  adds  a  certain  amount  of  alkalinity, 
but  far  below  the  proportion  contained  in  other 
vegetables. 

Phosphoric  acid  also  obtains  a  higher  rate, 
exceeded  only  in  cheese,  the  yolk  of  egg,  and 
oatmeal;  and,  being  almost  wholly  in  an  or- 
ganic form,  it  is  very  easily  assimilated.  Nu- 
clein,  lecithin,  diphosphates  of  oxymethylene, 
place  the  legumes  at  the  head  of  rephospha- 
ting  aliments.  Lime  and  magnesium  are  well 


LEGUMES— PULSE  209 

represented,  the  latter  a  bit  more  than  the 
former.  Iron  abounds  only  in  lentils. 

The  alimentary  value  of  legumes  is  consider- 
able. They  constitute  almost  a  complete  food, 
for  albuminoids  and  carbohydrates  are  present 
in  high  proportions.  Riibner  was  able  to  main- 
tain the  balance  of  nitrogen  and  carbonic  acid 
in  the  men  on  whom  he  experimented  by  giv- 
ing 520  grams  of  dry  peas  per  day.  But,  mind 
you,  results  like  these  are  of  no  other  than  a 
purely  experimental  value. 

The  moderate  cost  also  adds  much  to  their 
worth.  The  cheapest  calorific  unit  to  be  found 
is  that  of  the  legumes.  One  hundred  calories  of 
split  peas  cost  less  than  one  hundred  calories 
of  white  bread.  It  requires  only  one  kilogram 
(a  little  more  than  two  pounds)  of  split  peas  to 
make  an  equivalent  of  1,400  grams  (about  three 
pounds)  of  bread,  and  the  expense  is  smaller. 
To  this  must  be  added  the  ease  with  which  the 
legumes  can  be  kept  and  their  inalterability, 
factors  that  establish  them  as  a  food  of  the 
first  order,  well  adapted  for  provisioning  large 
masses  of  people. 

For  practical  purposes,  however,  it  is  well  to 
bear  in  mind  that  this  high  nutritive  poten- 


210  WHAT  SHALL   I    EAT? 

tiality,  especially  from  the  standpoint  of  super- 
alimentation,  needs  strong  correctives. 

All  legumes  absorb,  in  the  cooking,  large 
amounts  of  water;  for  instance,  300  grams  of 
dried  peas  make  1,200  grams  of  puree;  for 
beans  and  lentils  the  proportion  is  well  nigh  the 
same.  And  again,  intestinal  absorption  is  far 
from  being  perfect,  scarcely  ever  exceeding  91 
per  cent;  while  rice,  bread,  milk,  meat,  and 
pastes  attain  as  much  as  95  to  96  per  cent. 
Lastly,  they  produce,  especially  in  the  sick,  a 
feeling  of  fulness,  which  limits  the  ratio  of  in- 
gestion. 

PREPARATIONS   AND    METHODS   OF   USE 

To  render  legumes  digestible  and  assimilable 
they  must  be  hydrated  and  cooked. 

Hydration  is  accomplished,  preparatory  to 
cooking,  by  soaking  the  pulse  in  water — each 
variety  according  to  its  own  requirements,  until 
the  husk  is  softened  off. 

This  is  important,  for  the  water  transforms 
a  part  of  the  starch  into  amylodextrin,  thus 
facilitating  the  process  of  digestion  and  absorp- 
tion in  the  canal.  It  equally  modifies  the 
cellulose  and  makes  it  more  absorbable.  Legu- 


LEGUMES— PULSE  211 

min  has  a  tendency  to  form,  during  cooking, 
insoluble  combinations  with  the  carbonate  of 
lime  contained  in  the  water  which  indurates 
or  toughens  the  mess.  For  this  reason  soft 
water  should  be  employed.  Hard  water  may 
be  softened  by  adding  from  3  to  5  grams  of 
bicarbonate  of  soda  per  liter. 

The  rule,  almost  universally  observed,  to  cook 
legumes  just  for  one  hour,  we  consider  ill  ad- 
vised. It  offers  several  disadvantages  which  we 
may  as  well  point  out  at  once.  It  is  a  mistake 
to  cook  pulse  in  a  large  volume  of  water  which 
is  afterward  poured  away,  for  in  this  manner 
a  certain  amount  of  sugar  is  drained  off,  thus 
lowering  the  nutritive  quality  of  the  food  and 
diminishing  its  digestibility.  It  wastes  the  aro- 
matic essences,  which  flatter  both  taste  and 
smell  and  stimulate  the  physiological  secretions 
of  the  stomach  produced  by  psychic  reflex  action. 
It  also  entails  a  heavy  loss  of  important  min- 
eral salts  which  are  dissolved  by  the  water  in 
cooking. 

Legumes  should  be  cooked  over  a  slow  fire 
in  the  smallest  amount  of  water  compatible, 
and  in  a  vessel  hermetically  sealed.  It  is  easy 
enough  nowadays  to  find  utensils  specially  de- 


WHAT  SHALL   I    EAT? 

signed  for  that  purpose.  We  shall  revert  to 
this  subject  later  on. 

The  seasoning  of  legumes  can  easily  be  ac- 
complished. Butter  or  oil  will  add  the  re- 
quired amount  of  fats  which  are  lacking. 

Sick  persons  should  eat  them  in  the  shape  of 
a  thick  soup  (puree),  or  use  only  the  husked 
article,  for  the  peel  is  hard  to  digest,  overloads 
the  stomach,  and  irritates  the  bowels.  Neverthe- 
less, this  has  its  disadvantages  also.  The  puree 
is  swallowed  too  rapidly,  without  proper  mastica- 
tion, which  is  bad  for  the  stomach  and  deprives 
intestinal  peristalsis  of  that  residue  of  cellulose 
which  serves  as  a  physiological  stimulus.  This 
form  of  diet  should  be  restricted  to  cases  of 
necessity  only. 

REACTIONS 

a.  Digestive.  — If  we  consider  the  constituents 
only,  we  have  seen  that  they  are  almost  the 
same  as  in  cereals,  excepting  the  large  per- 
centage of  albumin  which  slightly  embarrasses 
the  gastric  action.  But  then  it  is  chiefly  the 
cellulose  shell  which  retards  the  attack  by 
the  ferments  and  impairs  digestibility.  The 
necessity  of  prolonged  mastication  to  com- 


LEGUMES— PULSE  213 

plete  the  work  of  cooking  will  thus  be  ap- 
parent. 

In  the  intestines  the  dry  legumes  react  at 
once,  through  their  albumin  and  starch,  on  the 
glandular  system,  principally  the  pancreas,  and 
through  the  cellulose  on  the  muscular  system. 
If  ingested  in  overlarge  quantities  or  crowded 
into  the  canal  otherwise  overtaxed,  they  quickly 
provoke  acid  or  gaseous  fermentation. 

b.  General  and  Excretory.  — From  this  double 
standpoint  they  occupy  a  place  exactly  midway 
between  the  cereals,  on  account  of  the  large  vol- 
ume of  nitrogen  and  nuclein.  Nevertheless, 
they  should  be  rather  counted  among  the  stim- 
ulating and  toxic  aliments,  being,  as  it  were,  a 
vegetable  meat. 

After  what  we  have  said  about  the  nutritive 
qualities  of  the  legumes,  it  will  be  easy  to  find 
the  place  which  they  should  occupy  in  the  diet 
of  the  artisan  and  laborer  largely  as  a  substitute 
for  meat,  of  the  soldier,  of  the  masses  in  general, 
and  of  anybody  in  sound  health  and  endowed 
with  a  good  digestion,  especially  in  the  winter 
months.  In  the  summer-time,  when  our  calor- 
ific needs  are  less  acute,  preference  should  be 
given  to  the  fresh  article. 


214  WHAT  SHALL   I    EAT? 

Legumes  are  a  particular  requisite  for  the  diet 
in  childhood  and  during  the  period  of  adoles- 
cence, when  the  construction  of  tissue  demands 
the  aid  of  phosphorous  elements,  of  lime  and 
magnesium,  all  of  which  are  furnished  lavishly 
by  the  legumes.  In  cases  for  remineralization 
and  rephosphatization  in  convalescence,  and, 
above  all,  in  tuberculosis,  they  will  answer  the 
call. 

In  all  these  cases  the  dried  legumes  should  be 
taken  entire.  To  advance  gastric  tolerance  all 
that  is  required  is  thorough  mastication.  How- 
ever, there  are  conditions  in  which  they  will  not 
be  supported,  except  in  the  shape  of  thick  soups, 
or  when  decorticated.  Among  these  we  give 
mention  to  dyspepsia,  either  hypo-  or  apeptic; 
in  the  average  cases  of  dilatation,  and  in  gastritis 
of  long  standing;  also  in  secondary  dyspepsia  of 
tuberculosis,  in  anemia,  and  neurasthenia.  Like- 
wise in  enter ocolitis,  enteritis,  and  enteroptosis. 
Here  preference  should  be  given  to  peas,  lentils, 
and  kidney-beans. 

For  children  afflicted  with  hereditary  arthritis, 
whose  intestines  are  so  often  delicate  and  irrita- 
ble, they  form  an  important  part  of  the  diet. 

Finally,    there  are   cases  in  which  their  use 


LEGUMES— PULSE  215 

is  absolutely  interdicted  in  any  shape  or  form. 
First  of  all,  in  diabetes,  not  only  because  of  their 
high  percentage  of  carbohydrates,  but  also  be- 
cause they  belong  to  the  foods  hardest  to  digest, 
following  immediately  after  the  saccharose  and 
starch  of  bread. 

Then,  in  obesity  and  hepatic  affections,  as  they 
possess  a  strong  tendency  to  be  transformed  in 
the  liver  into  fatty  substances;  likewise  in  hy- 
perchlorhydria  and  in  the  major  gastric  dila- 
tations, where  their  hyperacidity  arrests  the 
digestion  of  starch  and  provokes  putrefaction. 

Lastly,  in  arthritis,  not  so  much  because  they 
are  too  nutritive,  but  on  account  of  their  tend- 
ency to  produce  uric  acid.  Gout,  gravel,  rheu- 
matism, migraine,  neuralgia  are  danger-signals 
for  removing  them  altogether  from  the  diet  list. 
Scleroma,  cardiac  affections,  and  Bright3 s  disease 
belong  to  the  same  catalogue. 

PARTICULARS 

1st.  Lentils. — These  are  particularly  valua- 
ble from  every  point  of  view,  because  the  per- 
centage of  cellulose  is  low  and  they  are  easy  to 
digest.  On  this  claim  they  are  of  special  bene- 
fit to  dyspeptics  and  in  enteritis.  Their  large 


216  WHAT  SHALL   I   EAT? 

content  of  iron  gives  them  the  preference  over 
all  the  other  legumes.  Being  ferruginous  they 
rank  in  line  with,  or  immediately  after,  pud- 
ding, the  yolk  of  egg,  certain  green  vegetables, 
and  certain  fruits,  and  therefore  are  wholesome 
food  for  anemics. 

2d.  Beans. — There  is  a  large  variety,  nota- 
bly white  and  brown  beans,  whose  composition 
varies  but  little.  Rich  in  cellulose,  and  con- 
taining a  slightly  higher  percentage  of  fats  than 
the  other  legumes,  they  are  less  digestible. 
They  ferment  easily  and  give  rise  to  formations 
of  gas,  for  which  reason  they  are  especially  con- 
traindicated  in  flatulent  dyspepsia.  But  they 
are  rich  in  phosphorus  and  magnesium,  hence 
beneficial  to  adults  and  growing  youths  in  good 
health. 

Kidney-beans  are  much  tiner  and  much  more 
easy  to  digest  than  the  other  kinds,  but  they 
are  also  richer  in  xanthic  bodies. 

String-beans  are  almost  on  a  par  with  fresh 
vegetables,  of  which  we  shall  speak  presently. 
The  pulp  represents  less  than  9  per  cent  of  their 
weight,  the  rest  of  92  per  cent  is  water.  They 
contain  not  more  than  4  per  cent  of  carbohy- 
drates at  the  utmost,  principally  in  the  form  of 


LEGUMES— PULSE  217 

nuclein,  inosite,  or  amylaceous  bodies  which  do 
not  produce  glucose.  In  diabetes  they  are  per- 
missible. 

But  they  are  contraindicated  in  arthritis, 
uricemia,  oocaluria,  and  in  diseases  of  the  liver, 
by  reason  of  their  heavy  content  of  uric  and 
oxalic  acids. 

3d.  Peas. — On  account  of  their  composition, 
their  percentage  of  nitrogen,  fats,  and  starch, 
they  are  midway  between  lentils  and  beans. 
The  marked  presence  of  cellulose  makes  them 
equally  as  hard  to  digest  as  beans.  Split  peas, 
which  are  deprived  of  the  husk,  are  more  nutri- 
tious and  better  tolerated  than  dried  peas. 
Both  are  eaten  in  the  shape  of  thick  soups 
(puree).  To  prevent  putrefaction  it  is  wise  to 
add  small  pieces  of  toasted  or  fried  bread  (sippet 
or  crouton),  which  insures  slower  eating  and 
better  mastication. 

Fresh  green  peas  contain  relatively  little 
sugar,  though  a  trifle  more  than  string-beans. 
But  they  contain  quite  an  appreciable  amount 
of  xanthic  bodies,  entailing  the  corresponding 
contraindications.  Well  mashed  they  are  easily 
digested,  and  the  cellulose  is  assimilated  to  a 
large  extent. 


218  WHAT  SHALL   I    EAT? 

4th.  Broad  Beans. — They  excel  in  cellulose 
(we  have  classified  the  legumes  in  accordance 
with  the  increasing  percentage  of  cellulose: 
lentils,  kidney-beans,  peas,  broad  beans).  It 
follows  that  the  latter  are  a  dish  relatively 
heavy  and  indigestible.  In  spite  of  the  abun- 
dance of  phosphorus,  and,  above  all,  of  mag- 
nesium (no  other  food  contains  more),  they  can- 
not be  recommended,  except  to  robust  stomachs. 
Decorticated,  they  are  a  little  bit  easier  to  di- 
gest; but  for  farm  laborers  they  are  an  excel- 
lent food. 


POTATOES 

POTATOES  are  the  most  widely  spread  type  of 
tubers.  Their  properties  place  them  between 
the  cereals  and  legumes  on  the  one  hand,  and 
the  green  vegetables  on  the  other.  The  pre- 
ponderance of  water  depresses  their  food  value. 
The  percentage  of  carbohydrates  is  low,  and 
that  of  albumin  still  more  so.  The  mineral 
value  of  phosphoric  acid,  lime,  and  magnesium 
is  superceded  by  potash  and  soda,  and  confers 
upon  them  a  higher  alkalinity  than  that  found 
in  fresh  vegetables. 

COMPOSITION   AND   ALIMENTARY    POWER 

Albumin 1.73 

Fats 0.11— Chlorid  .  .    0.01 

Carbohydrates  .  .    20.00— Purin  .  .  .    0.003 

Ash 0.77 

Available  calories  =  90 

These  figures,  which  represent  the  mean 
composition,  vary,  however,  not  only  in  the 
different  varieties,  but  also  with  the  age  of  the 

219 


220  WHAT  SHALL   I    EAT? 

potato.  In  the  spring  of  the  year,  for  instance, 
their  content  of  carbohydrates  is  higher  than  in 
the  autumn  and  winter  months. 

The  carbohydrates,  which  are  about  the  only 
nutritive  quality  possessed  by  the  potato,  are 
present  in  the  shape  of  starch  or  yeast.  Heat 
transforms  the  starch  into  sugar;  but,  when  the 
potato  is  exposed  to  cold  for  some  time,  this 
phenomenon  is  reversed.  If  kept  too  long  in  a 
warm  place,  the  potato  begins  to  sprout,  and 
the  change  of  starch  into  sugar  becomes  abso- 
lute. 

The  content  of  nitrogen  is  small,  and  nearly 
half  of  it  manifests  itself  not  in  the  shape  of 
albumin,  but  as  glutaric  acid,  i.e.,  asparagin, 
leucin,  and  tyrosin. 

The  ash  contains  only  a  small  amount  of 
phosphoric  acid,  a  little  magnesium,  and  a  still 
smaller  quantity  of  lime,  but  up  to  60  per  cent 
of  potassium.  For  this  reason  potatoes  should 
never  be  eaten  without  salt.  Bunge  demon- 
strated that  potassium,  ingested  in  this  man- 
ner, splits  the  sodium  chlorid  in  the  blood  and 
forms  a  chlorid  of  potassium  which,  if  present  to 
excess,  is  eliminated  through  the  urine.  This 
loss  of  chlorin  must  therefore  be  restored  by 


POTATOES 

other  means,  because  the  potato  contains  scarce- 
ly any  trace  of  it.  The  potassium  in  the  po- 
tato is  partly  combined  with  organic  acids  and 
partly  with  phosphoric  acid,  and  makes  the  ash 
strongly  alkaline.  Iron  is  represented  in  fair 
quantities. 

The  alimentary  value,  contrary  to  popular 
belief,  is  small,  because  intestinal  absorption  is 
imperfect.  The  figure  90  given  above  refers 
only  to  the  eatable  portions.  In  potatoes  bought 
at  the  grocery  the  loss  is  heavy,  for  they  do  not, 
as  a  rule,  yield  more  than  69  calories  to  every 
100  grams. 

METHODS   OF    PREPARATION 

For  the  purpose  of  modifying  the  starch  and 
rendering  it  more  assimilable,  cooking  is  indis- 
pensable. The  method  of  cooking,  therefore, 
as  well  as  the  manner  of  seasoning,  greatly 
enhances  the  nutritive  quality  of  the  potato, 
while  weight  is  not  appreciably  affected  by  boil- 
ing. One  kilogram  (about  two  pounds)  of  raw 
potatoes  makes  just  1,000  grams  when  boiled. 
We  must  not  lose  sight  of  the  fact  that  a  part 
of  the  essential  salts  is  lost  in  the  water.  This 
loss  may  be  compensated  for  by  the  addition  of 


222  WHAT  SHALL   I   EAT? 

kitchen  salt.  However,  it  may  be  circumvented 
by  baking,  puffing,  or  steaming  the  potatoes. 
Baked  potatoes  lose  one-fourth  their  weight  by 
evaporation,  and  therefore  are  commendable. 
When  puffed  or  steamed,  scarcely  any  change 
in  the  weight  takes  place. 

Mashed  potatoes  are  good  food,  especially 
for  dyspeptics.  They  absorb  nearly  their  own 
weight  of  water.  The  addition  of  milk  largely 
increases  the  rate  of  albumin  and  fats,  therefore 
that  of  nutrition. 

Potatoes,  fried,  possess  almost  double  the 
alimentary  force  on  account  of  the  large  elimi- 
nation of  water  and  the  addition  of  fat;  but 
they  are  harder  to  digest. 

When  they  are  prepared  with  butter  or  drip- 
ping, or  made  into  a  potato  salad,  the  same  rule 

applies. 

REACTIONS 

a.  Digestive.  — Of  all  vegetable  foods  potatoes 
are  the  easiest  on  the  stomach.  Nitrogen  is 
reduced  to  a  minimum;  starch  is  present  in  the 
shape  of  finest  division;  the  cellulose  is  tender, 
and  small  in  proportion.  But  seasoning  may, 
as  we  have  seen,  affect  the  digestibility  very 
smartly. 


POTATOES  223 

The  influence  on  the  intestinal  digestion  is 
equally  propitious,  inasmuch  as  the  carbohy- 
drates stimulate  pancreatic  secretion,  and  peri- 
stalsis receives  a  moderate  and  beneficent  reflex 
action  from  the  cellulose  residue.  Putrefaction 
is  rarely  observed. 

b.  General. — Potatoes  have  a  rather  liberal 
effect  on  the  nutritive  process  and  on  the  cellu- 
lar system  in  general.     Being  poor  in  nitrogen, 
but   rich  in  ternary  bodies,   they  undoubtedly 
restrain  the  energy  of  the  economy.     By  their 
wholesome  action  on  the  digestive  organs  they 
improve  the  general  tone  of  the  whole  system. 
Their    alkalinity   advances  oxidation   and    the 
combustion  of  cellular  waste. 

c.  Renal.  — The  abundance  of  potassium  salts 
makes  them  slightly  diuretic. 

INDICATIONS   AND   CONTRAINDICATIONS 

We  have  no  hesitancy  in  declaring  potatoes  a 
good  food  article,  although  the  nutritive  value 
is  below  that  of  bread  and  pulse,  and  the  pur- 
chase price  is  higher.  One  thousand  calories  of 
potatoes  cost  45.82  per  cent  more  than  one 
thousand  calories  of  white  bread,  and  42. 40  per 
cent  more  than  one  thousand  calories  of  split 


224  WHAT   SHALL   I    EAT? 

peas.  They  are  by  no  means  merely  the  poor 
man's  food,  for  they  grace  the  rich  man's  table 
perhaps  even  more. 

In  pathological  conditions  the  indications  cen- 
ter partly  in  their  digestibility  and  partly  in 
the  high  rate  of  alkalinity.  The  first  quality 
addresses  itself  to  weak  and  disordered  stom- 
achs, i.  e. ,  to  dyspeptics  by  insufficiency,  to  ane- 
mics,  debilitated  persons,  and  convalescents,  by 
all  of  whom  they  are  well  supported,  provided 
they  reach  the  table  either  baked  or  steamed,  or 
mashed  with  milk  or  a  small  allowance  of  fresh 
butter. 

In  intestinal  troubles  the  potato  proves  like- 
wise of  benefit,  especially  in  cases  of  constipa- 
tion, so  common  among  women,  when  they 
should  be  consumed  at  the  midday  meal. 

In  Bright' 's  disease  or  cardiac  affections  baked 
and  mashed  potatoes  should  figure  in  the  menu, 
because  the  absence  of  chlorin  and  the  high 
percentage  of  potassium  makes  them  a  diuretic 
food.  If  we  admit  the  theory  of  Bunge,  they 
should  be  of  decided  use  in  cases  of  oedema. 

Their  high  alkalinity  points  to  them  in  hyper- 
acidity and  arthritis.  Besides,  although  "fill- 
ing, ' '  they  are  less  nutritive  and  certainly  do 


POTATOES  225 

not  favor  superalimentation.  Arthritics  may 
safely  risk  eating  meat  and  fish  garnished  with 
potatoes  so  long  as  the  latter  are  not  fried, 
"sautees, "  or  buttered. 

If  potatoes  in  large  portions  have  been  spe- 
cially recommended  in  cases  of  diabetes,  it  cer- 
tainly was  on  the  score  of  their  high  alkalinity. 
It  is  true,  Labbe  has  shown  that  the  starch  in 
the  potato  is  the  largest  portion  of  its  utilizable 
components,  but  this  quality  does  not  seem  of 
sufficient  importance  to  permit  of  an  explana- 
tion of  the  many  cases  in  which  improvement 
has  been  observed.  On  the  contrary,  as  we 
have  said  about  arthritis,  the  diabetic  who 
stands  in  need  of  fats  should  season  his  pota- 
toes with  butter,  dripping,  or  oil. 

In  gout  or  liver  complaints  they  are  also  a 
welcome  nutrient,  readily  taking  the  place  of 
bread,  which  is  acid  and  harder  to  digest. 

In  obesity  they  are  harmful.  Stoutness  is  fre- 
quently due  to  the  abuse  of  farinaceous  foods  in 
general,  and  of  potatoes  in  particular. 


226  WHAT  SHALL   I    EAT? 

CHANGES 

When  the  potato  sprouts,  it  often  happens 
that  solanin,  which  is  formed  at  the  expense  of 
albumin,  increases  in  very  disquieting  propor- 
tions. From  0. 04  it  may  rise  to  0. 60  gram  per 
kilogram  and  cause  poisoning,  diarrhea,  vomit- 
ing, or  dilation  of  the  pupils.  Sprouting  pota- 
toes should  never  be  consumed.  If,  however, 
their  use  cannot  be  avoided,  it  is  well  to  re- 
member that  solanin  is  centered  chiefly  around 
the  sprouts,  and  that  by  peeling  thickly  and 
cutting  out  deep  the  shoots  the  danger  of  pois- 
oning is  minimized. 

THE   USE   OF  FARINACEOUS   FOODS   AND   OF 
LEGUMES  IN  INFANCY   AND  CHILDHOOD 

Toward  the  end  of  the  first  year  milk  be- 
comes insufficient  as  a  nourishment  for  the  child 
and  farinaceous  substances  must  be  called  into 
service  which  afford  new  elements  in  new  pro- 
portions, favoring  the  development  of  the  diges- 
tive organs  and  of  the  body  in  general.  They 
are  particularly  useful  when  inflammation  of 
the  bowels  makes  milk  toxic  and  dangerous. 
Recent  experiments  have  shown  what  excellent 


POTATOES  227 

results  may  be  obtained  in  such  cases  by  the  ad- 
ministration of  light  farinaceous  foods,  and  with 
soups  made  from  legumes.  We  will  add  here  a 
few  words  about  their  twofold  usefulness  in  the 
healthy  as  well  as  in  the  ailing  infant. 

The  flour  we  refer  to  is  either  obtained  from 
cereals — barley,  oats  (gruel),  maize,  rice;  or 
from  legumes — lentils,  peas;  or  from  tubers — the 
fecula  of  potatoes,  tapioca,  arrowroot. 

With  the  exception  of  the  last  three  men- 
tioned, we  know  already  their  relative  composi- 
tion. l 

The  fecula  of  potatoes  represents  starch  al- 
most in  its  pure  state.  Tapioca  is  a  fecula  de- 
rived from  a  plant  called  manioc,  which  grows 
in  Brazil.  When  treated  by  heat  it  becomes 
translucent. 

Arrowroot  is  a  fecula  made  from  a  plant 
growing  in  the  Antilles;  it  is  called  maranta 
indica. 

Car  bo- 
Albumin.        Fats.          hydrates.  Ash.       Calories. 

Fecula  of  potato .    0.74       0.05       78.32       0.43       324 

Tapioca 0.17       0.37       84.50       0.09       349 

Arrowroot 0.88      0.18      82.50       0.20      344 

1  The  flour  made  from  peas  and  lentils  is  practically  of  the 
same  composition  as  that  of  dried  legumes,  of  which  we  have 
already  given  the  analysis. 


228  WHAT  SHALL   I    EAT? 

Nitrogen  and  fats  are  wanting,  but  the  salts 
are  abundant.  Starch  really  represents  the  true 
nutritious  value  which  is  considerable. 

These  different  products  have  a  special  claim 
each  as  baby  foods  by  a  series  of  qualities  which 
is  common  to  them  all,  but  is  more  or  less  pro- 
nounced in  each  individual  variety. 

1st.  They  are  nutrients  very  easy  to  digest; 
they  require  but  the  slightest  exertion  on  the 
part  of  the  stomach  as  well  as  of  the  intestines. 
Yet,  from  this  point  of  view,  their  value  is  un- 
equal and  their  composition  permits  of  making 
a  scale  of  digestibility  of  which  we  shall  speak 
anon. 

2d.  They  exert  an  antiseptic  action  upon  the 
intestinal  flora.  We  have  dwelt  on  this  ques- 
tion to  some  length  (page  170),  so  need  not  re- 
cur to  it  here;  but  this  quality  is  of  particular 
value  in  the  infant  forever  exposed  to  the  dan- 
gers of  intestinal  infection. 

3d.  With  the  exception  of  the  feculae,  the 
percentage  of  mineral  bodies  is  very  high,  a 
quality  to  be  much  appreciated  at  an  age  when 
the  organism  is  building  its  frame  and  laying 
the  mineral  foundation  for  its  cellular  sys- 
tem. Organic  phosphorus,  which  is  so  plentiful 


POTATOES  229 

among  them,  is  a  powerful  aid  in  the  proper  ad- 
justment of  the  chalks  and  phosphorus  in  the 
osseous  tissues. 

4th.  Their  nutritive  power  is  high,  as  the 
table  given  above  shows.  Yet  danger  lurks  in 
this  advantage,  and  the  child  must  be  con- 
stantly guarded  against  overfeeding. 

5th.  They  keep  for  a  long  time  without  un- 
dergoing a  change.  While  traveling  during 
the  hot  weather  season,  when  the  milk  goes 
wrong  so  easily,  they  are  most  convenient  arti- 
cles. 

For  the  normal  child,  whose  digestive  tube  is 
in  good  shape,  these  flours  may  be  mixed  with 
the  milk,  boiled  for  fully  five  minutes  in  order 
to  facilitate  the  digestion  of  starch,  and  given 
in  drafts  gradually  more  concentrated  and  in- 
creased in  amount.  A  systematic  progression 
should  be  followed  not  only  as  to  quantity,  but 
also  as  to  the  quality  of  the  flours  used,  espe- 
cially during  artificial  and  mixed  nursing. 

Previous  to  the  sixth  month  the  digestive  fer- 
ments are  but  little  developed  in  the  baby,  and 
milk  alone  should  be  given. 

After  the  sixth  month,  when  the  salivary  and 
pancreatic  juices  begin  to  exert  their  influence, 


230  WHAT  SHALL   I    EAT? 

only  starchy  flours  should  be  added:  fecula  of 
potato,  cream  of  rice,  arrowroot,  and  tapioca. 

We  put  tapioca  at  the  end  of  the  list,  because 
it  is  a  trifle  harder  to  digest  than  the  rest. 

After  the  twelfth  month  flour,  slightly  al- 
buminized, may  be  introduced,  wheat-meal, 
barley,  rye,  maize,  oats  (all  given  here  in  the 
order  of  their  digestibility). 

During  the  third  year,  or  sooner  or  later  ac- 
cording to  the  digestive  aptitude  of  the  child, 
flours  rich  in  albumin  may  be  employed;  len- 
tils, peas,  beans.  Each  of  these  should  be  given 
alternately. 

A  regular  system  of  rotation  should  be  estab- 
lished and  the  child  should  not  be  limited  to 
one  variety  only. 

However,  the  flour  made  from  legumes,  being 
highly  nitrogenized  and  rich  in  xanthic  bodies, 
must  be  rather  eschewed  in  children  with  deli- 
cate stomachs,  especially  when  subject  to  ar- 
thritis or  eczema. 

When  nursed  at  the  breast,  these  broths  can- 
not be  given  until  the  child  has  been  weaned, 
when  the  method  of  procedure  will  be  quite  sim- 
ple, but  the  child  should,  nevertheless,  be  sub- 
jected to  methodical  regulations. 


POTATOES  231 

As  for  quantity,  careful  watching  is  no  less  re- 
quired. Between  six  and  nine  months  it  is  suffi- 
cient to  add  one  teaspoonful  of  the  broth  to  the 
milk  once  a  day.  By  and  by  the  amount  may 
be  increased,  keeping  a  strict  account  of  the 
daily  rations,  always  remembering  that  one 
generous  teaspoonful  of  flour  weighs  about  10 
grams,  and  consequently  represents  an  average 
of  350  calories. 

In  cases  of  enteritis  and  gastroenteritis,  so  com- 
mon and  of  such  serious  consequence  in  the  first 
tender  years  of  life,  and  when  milk  is  calculated 
to  aggravate  the  trouble,  the  cereals  and  le- 
gumes will  render  signal  services,  but  then  the 
method  of  employment  differs.  The  lack  of  di- 
gestive juices  and  the  fear  of  putrefaction  de- 
mand their  application  in  very  liquid  and  the 
least  nutritive  form.  Cereal  decoctions,  and 
broths  made  from  legumes,  are  among  the  prep- 
arations most  in  use.  We  give  two  reliable 
recipes. 


232  WHAT  SHALL   I    EAT? 

CEREAL  DECOCTION  ACCORDING  TO   COMBY 

Wheat 

Pearl  barley 


Crushed  maize 

Dried  beans,  shelled  and  unshelled 
Lentils,  shelled  and  unshelled.  .  .  . 
Dried  peas,  shelled  and  unshelled 


30  grams  of  each,  or 
1  good  soupspoonful 


Put  into  3  liters  of  water,  boil  thoroughly  for  three 
hours.  Add  1  liter  of  water  and  5  grams  of  salt.  Then 
strain.  It  should  yield  1  liter  of  broth. 

BROTH    MADE    FROM    LEGUMES   AFTER 
MERY 

Potatoes 60  grams 

Carrots 45     " 

Turnips 15     " 

Dried  peas 6     " 

Dried  beans 6     " 

Water 1  liter 

Soak  the  dried  legumes  first  in  cold  water.  Bring  the 
water  to  a  boil  and  add  the  other  vegetables.  Boil  for  a 
quarter  of  an  hour  in  an  earthen  casserole  or  a  porce- 
lain dish  provided  with  a  cover.  Add  5  grams  of  salt. 
Strain. 

These  two  preparations,  which  may  be  varied 
ad  libitum,  have  a  strong  compound  of  mineral 
substances,  and  for  that  reason  make  excellent 
broths.  As  they  ferment  or  turn  sour  very  eas- 


POTATOES  233 

ily,  it  is  wise  to  keep  them  in  a  covered  dish  and 
in  a  warm  (not  hot)  place,  but  not  longer  than 
twenty-four  hours.  The  nutritive  coefficient  is 
rather  of  a  moderate  degree.  They  represent, 
so  to  speak,  a  sort  of  water  diet;  but  have,  espe- 
cially the  broth  made  from  legumes,  the  advan- 
tage of  maintaining  the  mineral  reserves  in  the 
organism.  The  predominance  of  inorganic  ele- 
ments, chiefly  that  of  sodium  chlorid,  is  held 
by  many  authorities  to  constitute  the  basis  of 
their  therapeutic  efficiency. 

They  certainly  form  an  excellent  substitute 
for  the  rigid  water  diet,  especially  in  acute  dis- 
eases in  which  salts  (liquid  or  crystallized)  pre- 
vail. The  treatment  should  not  be  protracted 
beyond  a  period  of  ten  days;  neither  should  the 
broths  be  given  during  the  first  six  months  after 
birth.  —  (Mery. ) 

At  the  end  of  ten  days  more  solid  feeding 
should  be  resumed,  beginning  with  buttermilk, 
light  soups  made  from  fecula  of  rice,  gruel,  or 
such  preparations  as  we  have  referred  to  already 
under  the  head  of  substitutes  for  milk.  Great 
caution  is  advisable  in  the  resumption  of  a  heav- 
ier diet.  It  should  not  be  started  until  all  the 
morbid  symptoms  have  completely  disappeared. 


GREEN  VEGETABLES 

THIS  class  comprises  all  those  vegetables  which 
are,  as  a  rule,  consumed  immediately  after  they 
have  been  gathered.  They  are  also  known  un- 
der the  name  of  fresh  or  aqueous  vegetables, 
because  water  is  their  chief  constituent.  We 
prefer,  however,  the  denomination  of  "green 
vegetables. ' ' 

The  varieties  are  very  numerous  and  differ 
considerably  in  accordance  with  climatic  condi- 
tions and  surroundings.  We  shall  first  discuss 
the  properties  common  to  them  all,  and  then 
particularize  the  qualities  of  each  individual 
kind,  reverting  afterward  to  the  indications  and 
contraindications. 

COMPOSITION    AND    FOOD   VALUE 

Green  vegetables  are  individualized  by  three 
distinct  characteristics  common  to  them  all  in 
the  same  degree. 

1st.  Water  is  the  principal  factor  in  their 
composition,  varying  from  85  to  95  per  cent. 

234 


GREEN   VEGETABLES  235 

The  juice  of  fruits  and  even  milk  are  less 
watery. 

2d.  The  mineral  principles  are  very  weak. 
The  ash  represents  only  1  to  2  in  100  parts  of 
fresh  extract,  and  10  to  20  in  100  parts  of  the 
dried  compound.  Sodium,  and  again  potassium, 
preponderate  and  confer  upon  the  vegetables  a 
strong  percentage  of  alkalinity,  which  acts  as  a 
powerful  aid  in  combating  the  evil  effects  of 
hyperacidity,  against  which  man  has  forever  to 
guard  himself.  Silica  is  relatively  abundant. 
Phosphorus,  lime,  magnesium,  and  iron  are 
found  in  variable  quantities.  Chlorin  does  not 
reach  even  0. 01  per  cent. 

Besides  these  mineral  components,  which  are 
nothing  uncommon  in  all  our  foodstuffs,  a  few 
of  the  green  vegetables  show  also  traces  of  iodid, 
manganese,  arsenic,  and  fluor.  It  is  more  than 
probable  that  these  metalloids  play  an  impor- 
tant role  in  physiology.  Of  course,  when  pres- 
ent, they  enhance  the  mineralizing  value. 

3d.  The  abundance  of  cellulose,  although 
characteristic,  is  perhaps  also  of  smaller  signifi- 
cance, because  dry  legumes  when  not  decorti- 
cated, as  well  as  certain  fruits,  are  much 
richer  in  cellulose.  Nevertheless,  green  vegeta- 


236  WHAT  SHALL   I    EAT? 

bles  derive  a  great  deal  of  their  alimentary  power 
from  this  presence  of  cellulose,  at  least  one-half 
of  which  is  digested  and  absorbed,  but  only 
when  the  vegetable  is  just  from  the  garden.  In 
large  cities  this  condition  is  hard  to  obtain,  as 
the  supply  comes  from  a  distance  and  reaches 
the  consumer  in  all  possible  grades  of  freshness. 
This  defect  in  the  absorption  of  cellulose  is  one 
of  the  many  inconveniences  caused  by  the  diffi- 
culties accompanying  the  problem  of  provision- 
ing large  centers  of  population. 

The  real  caloriferous  principles,  such  as  albu- 
min, fats,  and  carbohydrates,  are  small  in  pro- 
portion. Nitrogenous  substances  scarcely  reach 
1  to  3  per  cent.  Among  them  we  must  mention 
a  small  amount  of  casein,  vegetable  legumin,  and 
phosphorated  nucleo-proteids,  all  present  in  the 
form  of  albumin.  The  rest  are  under  the  form 
of  amid,  amidoacids,  leucin,  tyrosin,  glutamic 
and  aspartic  acids,  all  of  very  doubtful  value. 

The  percentage  of  fats  is  small.  They  are 
partly  composed  of  phosphorated  lecithin. 

We  must  not  neglect  to  mention  the  aromatic 
substances,  nor  the  essences,  acid  and  piquant  to 
the  taste,  which  confer  upon  many  vegetables 
the  merit  of  genuine  condiments. 


GREEN   VEGETABLES  237 

The  carbohydrates  are  the  most  interesting 
part  to  study  in  the  garden  vegetables  which 
take  such  a  prominent  place  in  the  diet  of  diabet- 
ics. The  percentage  balances  between  3  and  5. 
Contrary  to  the  cereals,  starch  and  its  deriv- 
atives (cane-sugar  and  glucose)  do  not  represent 
even  one  per  cent.  In  their  stead  we  find,  how- 
ever, sugars  much  easier  supported  in  diabetes, 
such  as  levulose,  galactose,  mannite,  inosite, 
dulcite,  a  small  portion  of  inulin  and  dextrin, 
and  certain  mucilages  and  gums,  unfortunately 
hard  to  assimilate. 

The  nutritive  power  derived  from  all  these 
compounds  is  exceedingly  small,  as  by  far  the 
largest  amount  is  due  to  the  ternary  bodies. 
However,  this  defect  is  outweighed  by  the  abun- 
dance and  variety  of  inorganic  bodies.  Accord- 
ing to  Gautier,  man  draws  from  this  source 
about  one-fifth  of  his  daily  mineral  ration. 
This  is  the  reason  why  alkaline  and  minerali- 
zing foods  must  figure  in  our  diet. 

METHODS   OF    PREPARATION 

Fresh  vegetables  must  first  of  all  be  most 
carefully  examined  and  thoroughly  washed  in 
several  changes  of  water,  to  which  should  be 


238  WHAT  SHALL   I    EAT? 

added  some  kitchen  salt.  They  become  soiled 
by  the  ground  in  which  they  grow,  the  dust 
from  the  roads,  and  the  water  used  for  irrigation 
(especially  dangerous  in  the  vicinity  of  large 
cities).  If  cleanliness  is  required  in  every  food, 
it  is  trebly  needed  with  vegetables. 

Radishes,  long  and  round,  or  black  or  white, 
beet-root,  tomatoes,  onions,  artichokes,  may  be 
eaten  raw,  either  with  salt  or  vinegar  and  oil  to 
make  them  softer  and  more  digestible,  or  with- 
out. They  are  all  heavy,  and  must  be  prohib- 
ited in  dyspepsia  and  in  all  cases  of  intestinal 
disturbance;  but  in  the  normal  stomach  they  act 
like  stimulants  and  aperients,  and  have,  espe- 
cially in  the  summer-time,  a  tendency  to  whet 
the  appetite.  To  counteract  the  irritating  ef- 
fects of  the  aromatic  essences  contained  in  them, 
they  must  be  thoroughly  masticated. 

Often  a  prolonged  cooking  of  the  vegetables 
is  required  in  order  to  effect  the  softening  of 
cellulose  and  the  bursting  of  the  vegetable  cel- 
lules; it  assists  at  the  same  time  in  dissolving 
the  starchy  matters,  the  gums  and  mucilages, 
and  to  render  them  more  assimilable. 

We  have  already  given  hints  how  to  preserve 
in  the  cooking  the  nutritive  principles,  the  aro- 


GREEN   VEGETABLES  239 

matic  substances,  and  the  essential  salts.  We 
confine  ourselves,  therefore,  to  a  few  remarks 
here  about  the  importance  of  preventing  the 
waste  of  the  salts.  In  spinach,  for  instance, 
nearly  7  per  cent  of  the  mineral  content  may 
be  lost  by  pouring  away  the  water.  Yet  there 
are  certain  vegetables,  such  as  artichokes  and 
asparagus,  which  must  be  cooked  in  plenty  of 
water;  but  the  water  so  used  should  not  be 
thrown  away,  but  utilized  for  making  sauces  or 
vegetable  soups. 

It  is  quite  a  different  thing,  however,  when 
vegetables  are  prepared  for  diabetics.  In  this 
case  plenty  of  water  should  be  used,  in  order  to 
reduce  the  proportion  of  the  carbohydrates. 
Von  Noorden  recommends  even  to  cook  them 
twice  in  an  excess  of  water,  and  each  time  to 
pour  off  the  liquid. 

REACTIONS 

a.  Digestive.  — The  action  of  the  aqueous  veg- 
etables on  the  stomach  is  complex,  and  must  be 
properly  analyzed.  The  nutritive  principles, 
i.  e. ,  the  ternary  and  nitrogenous  bodies  are,  so 
to  speak,  a  negligible  quantity.  But  this  defect 
is  offset,  to  a  certain  extent,  by  the  higher  per- 


240  WHAT  SHALL   I    EAT? 

centage  of  the  savory  and  odorous  substances— 
those  aromatic  essences  which  slightly  stimulate 
the  gastric  secretions  and  act  as  substitutes  for 
condiments.  On  the  other  hand,  against  this 
benign  influence,  operates  the  inverse  action 
of  cellulose,  which  ferments  easily,  overburdens 
the  stomach,  retards  evacuation,  and  even  secre- 
tion, whence  arises  that  feeling  of  surfeit  so  fre- 
quently experienced  when  partaking  of  vege- 
tables. On  the  whole,  many  varieties  are  hard 
to  digest  unless  they  are  absolutely  fresh  and 
mashed,  or,  still  better,  strained. 

In  the  intestinal  canal  cellulose  produces  more 
essential  effects  by  provoking  intestinal  peristal- 
sis. With  some  it  acts  simply  by  mechanical 
contact;  with  others  the  reaction  is  indirect.  It 
undergoes  a  process  of  fermentation  and  is  trans- 
formed into  carbonic,  lactic,  sulphurous,  and  fat- 
ty acids,  which  continue  their  course  through 
the  muscular  system.  But  it  is  easy  to  under- 
stand how  readily  this  fermentation  may  be- 
come exaggerated,  thus  turning  the  advantage 
into  an  inconvenience,  and  the  vegetable  into  a 
carrier  of  putrefaction  and  flatulency. 

b.  General. — These  foodstuffs  have  a  very 
low  stimulating  power.  Their  action  is  vested 


GREEN   VEGETABLES  241 

principally  in  their  alkalinity,   which  advances 
oxidation  and  the  nutritive  process  in  general. 

c.  Renal.  — The  large  percentage  of  water  and 
potassium  renders  them  diuretic.  Yet,  some 
varieties  contain  elements  such  as  purin,  alka- 
loids, ether,  benzoic  acid,  which  act  as  irritants 
on  the  kidneys. 

INDICATIONS   AND   CONTRAINDICATIONS 

One  of  the  useful  qualities  of  fresh  vegetables 
undoubtedly  is  that  they  prevent  man  from  eat- 
ing too  much.  This  may  sound  paradoxical, 
yet  will  appear  justified,  if  we  remember  that 
bulky,  yet  less  nourishing  as  they  are,  they  soon 
provoke  a  feeling  of  satiety.  It  seems  that  by  a 
special  dispensation  of  Providence  they  appear 
on  our  tables  during  the  summer  months,  when 
the  excessive  heat  reduces  our  daily  needs  al- 
most automatically  and  without  giving  cause 
for  alarm.  Green  vegetables  are  essentially  a 
summer  food,  the  same  as  the  dry  legumes  are 
intended  for  the  winter;  and  both,  though  en- 
dowed with  different  calorific  values,  furnish  an 
abundance  in  mineral  compounds.  They  are 
more  appropriate  for  the  diet  of  the  well-to-do, 
of  heavy  eaters,  and  persons  of  sedentary  habits, 


242  WHAT  SHALL   I    EAT? 

than  for  the  man  who  performs  manual  labor, 
as  he  cannot  find  in  them  an  equivalent  for  the 
expenditure  of  muscular  exertion. 

Their  low  nutritive  power  puts  them  also  to 
the  fore  in  the  pathological  domain.  In  obesity, 
they  greatly  assist  in  reducing  the  pain  and  in- 
convenience occasioned  by  the  starving  process. 
All  regimens  prescribed  for  stoutness  contain 
green  vegetables  in  plenty. 

In  arthritis  the  same  profitable  results  may 
be  obtained.  Green  vegetables  are  precious  by 
reason  of  their  alkalinity  which  counteracts  the 
excessive  acidity  of  the  stomach,  and  of  cellu- 
lose which  relieves  constipation.  For  which 
reasons  they  should  undergo  a  process  of  most 
thorough  and  minute  mastication  to  forestall 
excessive  fermentation  in  all  cases  when  they 
are  employed  for  cathartic  purposes.  Moreover, 
a  careful  choice  should  be  made  among  the 
many  varieties,  rejecting  all  those  which  possess 
toxic  or  irritating  qualities. 

The  self-same  observations  are  applicable 
to  gout,  uricemia,  and  liver  complaints,  for 
which,  as  a  general  rule,  the  "grasses"  are 
suitable. 

In  diabetes  the  primary  indication  is  "green 


GREEN   VEGETABLES  243 

vegetables, ' '  for  in  every  form  they  are  service- 
able. They  fill  the  stomach  and  assuage  the 
pangs  of  hunger  so  exacting  in  this  disease. 
Not  only  is  the  percentage  of  carbohydrates  low 
and  still  more  reducible  by  proper  cooking, 
but  a  portion  of  it  is  present  in  a  form  which 
may  be  readily  utilized  by  the  economy:  levu- 
lose,  mannite,  inulin,  inosite.  According  to 
Gautier,  artichoke,  oyster-plant,  salsify,  chicory, 
lettuce,  onion,  leek,  and  Jerusalem  artichoke 
are  the  most  favored  varieties  in  this  respect. 
They  exercise  a  benign  influence  on  the  course 
of  the  disease,  by  reason  of  their  alkaline  and 
vegetable  albumin  contents.  —  ( Von  Noorden. ) 
For  the  same  reasons  they  are  indicated  in  re- 
nal complications  or  in  menacing  coma.  Finally, 
they  assist  in  digesting  the  fats  with  more  ease, 
which  is  so  important  a  point  in  diabetes,  thus 
correcting  somewhat  their  own  nutritive  insuffi- 
ciency. 

While  in  dyspepsia  from  fermentation  fresh 
green  vegetables  cooked  in  water  or  milk  are 
well  supported,  in  cases  of  hyperchlorhydria, 
chronic  gastritis,  atony,  and  dilatation^  small 
quantities  only,  if  well  cooked,  well  mashed,  or 
strained,  are  tolerated,  The  species,  too,  is  of 


244  WHAT  SHALL   I   EAT? 

importance  and,  such  varieties  as  are  eaten  raw 
must  be  strictly  prohibited. 

In  intestinal  affections,  with  a  tendency  to  in- 
flammation or  diarrhea,  green  vegetables  are 
ever  harmful;  but  for  constipation  they  are  ex- 
cellent. In  enterocolitis  they  should  be  used 
with  prudence,  and  only  when  strained  or  well 
mashed.  Still  greater  discretion  is  ordered  in 
ptosis  and  with  women  afflicted  with  lax  and 
irritable  bowels. 

Convalescents,  demineralized  and  anemic  per- 
sons will  derive  benefit  from  the  mineral  re- 
serves accumulated  therein,  which  assist  in  the 
reconstruction  of  the  tissues. 

In  tuberculosis,  on  the  contrary,  a  food  so 
alkaline  can  be  of  no  practical  value. 

In  diseases  of  the  skin,  the  heart,  and  the  kid- 
neys no  absolute  rule  can  be  laid  down,  as  every- 
thing depends  on  the  special  properties  of  each 
individual  variety. 


GREEN   VEGETABLES  245 

PARTICULARS 

Sprouts  and  Bulbs 

Carbo- 
Albumin.         Fats.  hydrates.  Ash.     Calories. 

Artichokes 2.64  0.25  15.04  0.66  75 

Asparagus 1.61  0.14  8.67  0.43  23 

Cabbage  (green) .  3.71  0.47  6.69  0.83  28 

Onion  (spring) ..  1.35  0.24  10.00  0.46  49 

Leek 2.00  0.39  7.20  0.85  42 

Artichokes. — The  lower  fleshy  part  of  the 
leaves  is  quite  nutritious,  but  very  rich  in  ex- 
tractives. Manganese  is  present  in  large  quan- 
tities. 

When  reduced  to  a  pulp  (puree)  they  are  well 
tolerated  even  by  a  weak  stomach,  but  prove 
slightly  irritating  to  the  kidneys.  In  gout  and 
arthritis  they  do  more  harm  than  good. 

Asparagus.  — The  eatable  part  is  the  sprout  of 
the  plant  before  it  has  exfoliated.  Its  distin- 
guishing feature  is  the  high  percentage  of  ex- 
tractive matter  (purin=  0.025  per  cent)  and 
of  iron  (9.92).  It  contains  also  aspargin  and 
a  substance  that  gives  a  peculiar  odor  to  the 
urine.  But  little  is  known  of  this.  Asparagus 
is  apt  to  irritate  and  congest  the  kidneys,  and, 
while  increasing  the  production  of  uric  acid,  it 


246  WHAT  SHALL   I   EAT? 

impedes  its  elimination.  Traces  of  manganese 
are  found  in  the  ash.  Dyspeptics  should  par- 
take solely  of  the  tips  when  quite  green,  and  in 
small  quantities  only.  In  arthritic  gout,  dis- 
eases of  the  kidneys,  of  the  heart,  and  the  liver, 
likewise  in  blennorrhagia,  it  is  better  to  abstain. 

Cabbage. — This  is  a  favorite  food  among  all 
the  nations  of  the  world.  Gautier  claims  that 
it  represents  one-fifth  of  all  the  green  vegetables 
consumed.  The  ancients  highly  extolled  its 
therapeutic  value,  and  it  is  still  employed  by 
quacks  and  charlatans. 

Its  chief  quality  consists  in  the  high  grade  of 
mineralization.  There  certainly  is  no  other 
food  that  can  outrank  it  in  this  respect;  phos- 
phorus, lime,  magnesium,  iron,  reach  a  height 
scarcely  ever  surpassed  in  any  other  food.  Be- 
sides, silica  is  plentiful,  especially  in  cauliflower, 
with  traces  of  manganese  and  arsenic.  Purin  is 
absent. 

It  is  rather  heavy  and  perhaps  the  hardest  to 
digest  among  the  green  vegetables,  and  makes 
a  flatulent  dish.  The  different  varieties  vary, 
however,  in  this  respect.  Cauliflower  is  the  easi- 
est in  the  lot,  then  come  savoy,  green  boiled 
cabbage,  and  Brussels  sprouts. 


GREEN   VEGETABLES  247 

The  culinary  art,  that  adds  fats,  grease,  lard, 
cream,  bacon,  and  pork,  still  further  increases 
the  indigestibility.  Only  robust  stomachs  can 
stand  large  helpings. 

Sauer-kraut,  however,  is  an  exception.  The 
leaves  of  the  cabbage-head  are  cut  into  shreds 
or  strips  and  macerated  for  not  less  than  ten  or 
twelve  days  in  salt  and  a  little  water  spiced  with 
bay  leaves,  peppercorns,  and  juniper  berries. 
Lactic  fermentation  makes  of  this  a  food  easy  to 
digest,  but  perhaps  a  little  toxic.  For  the  man 
in  prime  condition  it  is  an  excellent  nutriment; 
but  diabetic  persons  should  beware  of  it.  As  an 
antiscorbutic  food  it  would  prove  a  failure. 

Dyspeptics  may  partake  of  cauliflower  with 
discretion.  All  varieties  of  cabbage  must  be 
scratched  from  the  diet  list  of  cases  of  intestinal 
affections,  liver  complaints,  heart  disease,  albumi- 
nuria,  arthritis,  and  kindred  diseases. 

Onions. — The  nutritive  power,  especially  of 
raw  onions,  is  very  superior,  attaining  as  much 
as  300  calories  per  100  grams.  Whilst  car- 
bohydrates are  abundant,  ordinary  starch  is 
scarcely  represented.  The  acrid  essence,  so 
pungent  to  the  eye,  strongly  resembles  that  of 
mustard. 


248  WHAT  SHALL   I    EAT? 

Onions  are  used  a  good  deal  for  seasoning 
almost  anything — soups,  sauces,  stuffings,  etc. ; 
and,  as  they  have  a  stimulating  effect  on  the 
stomach,  they  prove  useful  in  anorexia,  hypo- 
chlorhydria,  in  chronic  gastritis  of  old  standing; 
but  in  the  other  forms  of  dyspepsia  they  should 
be  avoided. 

In  kidney  or  vascular  or  skin  diseases,  in  cys- 
titis and  blennorrhagia  they  are  prohibited. 

Leeks  are  similar  to  onions — richer  in  es- 
sences, but  less  nutritive. 

Garlic  is  a  condiment.  Its  active  principle  is 
sulphid  of  allyl.  It  is  a  gastric  stimulant  and 
an  intestinal  antiseptic.  Slightly  diuretic,  it  is 
yet  an  irritant  for  the  kidneys  and  vessels.  It 
should  be  avoided  in  nephritis,  cystitis,  and  in 
blennorrhagia.  Dyspeptics  should  treat  it  with 
mistrust.  By  reason  of  its  sulphurated  essence 
its  action  in  pulmonary  affections  is  anti- 
catarrhal. 


GREEN   VEGETABLES  249 

Roots  and  Beets 

Carbo- 
Albumin.      Fats.        hydrates.       Ash.  Calories. 

Carrots 0.95  0.25  10.03  0.73  47 

Turnips 1.10  0.16  7.30  0.65  56 

Salsify 3.44  1.06  12.15  0.53  74 

Beet-root  (red,  cooked)  1.36  0.08  9.22  0.80  44 

Celery  (knob) 1.64  0.14  8.15  0.62  41 

Carrots. — The  percentage  of  carbohydrates  is 
relatively  high — 7  out  of  9  per  cent  is  repre- 
sented by  cane-sugar.  The  rate  of  mineral 
matter  is  medium,  excepting,  perhaps,  lime, 
which  is  six  times  stronger  than  in  the  potato. 
The  nutritive  power  is  small,  unless  they  are 
prepared  with  butter  and  cream. 

Intestinal  absorption  is  defective,  even  more 
so  than  in  the  potato.  Carrots,  ingested  in  large 
quantities,  make  soft  and  pasty  salts.  They 
prove  useful  in  constipation  and  to  persons  of 
sedentary  habits.  Hepatics  may,  as  a  rule, 
make  extensive  and  more  or  less  justifiable  use 
of  them.  The  presence  of  sugar  puts  them  be- 
yond the  lawful  reach  of  diabetics.  If  thor- 
oughly cooked  and  mashed,  dyspeptics  need  not 
fear  them. 

In  turnips  the  carbohydrates  are  not  so  pro- 
nounced as  in  carrots,  though  the  taste  is  more 


250  WHAT  SHALL   I   EAT? 

sweetish.  They  are  slightly  stimulating,  but 
flatuous,  and  do  not  agree  with  dyspeptics  or 
diabetics. 

Salsify  is  a  rather  fibrous  food  and  not 
adapted  to  dyspepsia;  but  its  compound  of  inu- 
lin  makes  it  agreeable  to  diabetics.  The  oyster- 
plant  resembles  salsify  in  every  respect. 

Beet-root  should  be  cooked  and  mixed  with 
salads.  It  is  too  hard  to  digest  to  suit  dys- 
peptics, and  too  rich  in  sugar  to  appeal  to  dia- 
betics. Its  content  of  oxalic  acid  prohibits  its 
use  in  arthritis,  oxaluria,  and  atheromatous  af- 
fections. 

Radishes  and  horseradish  are  condiments 
rather  than  foods.  Sulphocyanate  of  allyl,  the 
active  principle  of  mustard,  imparts  to  them 
the  double  quality  of  acting  as  a  stimulant  to 
the  stomach  and  as  an  antiseptic  to  the  intesti- 
nal canal.  If  they  are  properly  chewed  and 
masticated,  their  use  is  quite  rational,  especially 
in  the  summer-time,  and  not  only  by  persons  in 
good  health,  but  also  in  a  number  of  diseases, 
such  as  diabetes  and  anemia.  But  when  the 
functioning  of  the  stomach,  liver,  heart,  and 
kidneys  is  defective,  they  become  harmful  to 
the  economy.  In  blennorrhagia  they  must  be 


GREEN   VEGETABLES  251 

avoided — horseradish    particularly.     They  con- 
tain arsenic. 

Herbaceous   Vegetables 

These  are  the  real  green  vegetables  and  pos- 
sess in  the  highest  degree  all  the  properties,  ad- 
vantages, as  well  as  inconveniences  of  which 
we  have  already  said  so  much. 

Carbo- 
Albumin.         Fats.         hydrates.         Ash.      Calories. 

Celery 1.35  0.21  5.80  0.92  31 

Chicory  (curly)  ..  1.47  0.11  3.10  0.58  20 

Cress 2.12  0.26  3.76  0.98  27 

Spinach 2.65  0.36  4.29  1.43  32 

Lettuce 1.10  0.27  2.91  0.66  19 

Sorrel 2.20  0.49  4.89  0.81  32 

Rhubarb 0.44  0.54  3.60  0.50  21 

Celery,  too  little  appreciated,  is  a  stomach 
and  heart  stimulant,  but  rich  in  cellulose,  to  be 
avoided  in  cystitis  and  blennorrhagia.  In  Eng- 
land it  is  reputed  to  possess  antigouty  proper- 
ties. 

Chicory  has  a  certain  bitter  by-taste  which 
enhances  its  aperient  and  stimulating  virtues. 
This  amaritude  is  still  more  pronounced  in  the 
endive.  Mineralization  is  weak,  except  in  wild 
chicory. 


252  WHAT  SHALL   I    EAT? 

Cress  is  an  excellent  appetizer  by  reason  of  its 
allyl  content.  It  is  also  rich  in  iodid,  and  on 
this  account  it  may  be  recommended  in  lym- 
phatic and  parathyreoid  troubles.  It  is  diuretic 
and  antiscorbutic. 

Spinach  is  particularly  rich  in  mineral  bodies. 
It  supercedes  all  others  in  calorific  value,  and 
also  in  the  percentage  of  mineral  content  of 
phosphorus,  lime,  magnesium,  and  iron.  It  is, 
therefore,  an  excellent  food  for  demineralized 
and  anemic  patients.  But  as  oxalates  prevail,  it 
is  harmful  in  hepatic  troubles,  in  atheroma,  ec- 
zema, albuminuria,  oxaluria,  arthritis,  and  gout. 
Fresh  and  carefully  cooked,  it  agrees  with  dys- 
peptics. 

Lettuce  is  sometimes  cooked  and  served  like 
spinach,  but  is  chiefly  eaten  as  a  salad,  like  dan- 
delion, corn  salad,  and  chicory. 

Irritable  stomachs  do  not  tolerate  salads  well, 
and  in  hyperchlorhydria  they  should  be  avoided. 

For  persons  of  sedentary  habits,  and  for  heavy 
arthritic  eaters,  as  well  as  in  constipation,  their 
application  will  prove  very  useful,  as  they  often 
serve  to  prevent  overeating,  act  gently  on  con- 
stipation, and  mineralize  and  alkalize  the  sys- 
tem. 


GREEN   VEGETABLES  253 

Sorrel  and  rhubarb  might  just  as  well  be 
counted  among  the  fruits.  The  high  percent- 
age of  oxalic  acid  is  their  particular  quality. 
All  contraindications  enumerated  under  the 
head  of  spinach  apply  here  with  double  force. 
Stomachs  that  are  overworked  or  in  an  irritable 
condition  cannot  stand  their  acidity. 

VEGETABLE   FRUITS 

Carbo- 
Albumin.      Fats,     hydrates.      Ash.  Calories. 

Eggplant  (Aubergine) .    1.07     0.22     5.30     0.39     28 

Melons 0.68     0.12     6.38     0.36     30 

Tomatoes 0.76     0.32     3.90     0.38     22 

Eggplant  has  not  yet  become  a  very  popular 
food;  melons  are  bad  for  diabetics,  and,  as  they 
are  apt  to  relax  the  bowels,  they  should  not  be 
recommended  to  persons  with  a  sensitive  and 
irritable  digestive  apparatus;  but  if  they  are 
thoroughly  matured,  dyspeptics  may  partake  of 
them  in  small  quantities  without  experiencing 
any  subsequent  inconvenience. 

The  tomato  has  an  acid  taste,  on  which  ac- 
count its  use  in  arthritis  has  for  a  long  time 
been  considered  obnoxious.  But  Gautier  has, 
by  very  careful  experiments,  demonstrated  that 
the  tomato  contains  but  slight  traces  of  oxa- 


254  WHAT  SHALL   I    EAT? 

lates,  and  that  the  ash  is  decidedly  alkaline. 
Therefore  no  reason  exists  why  arthritic,  gouty, 
and  anemic  individuals  should  not  eat  tomatoes 
without  unpleasant  consequences.  In  dyspepsia 
and  hyperacidity,  however,  they  should  be  re- 
moved from  the  menu,  unless  they  form  a  mere 
admixture  to  sauces. 

Gherkins  and  capers  we  look  upon  more  in 
the  light  of  condiments  than  vegetables.  In 
hyperchlorhydria  and  enterocolitis  they  are  pro- 
hibited. But  they  may  render  good  service  in 
dyspepsia  from  insufficiency,  chronic  gastritis, 
and  in  anorexia,  in  tuberculosis,  and  anemia. 

Mushrooms 

Carbo- 
Albumin.      Fats.      hydrates.      Ash.  Calories. 

Esculent  boletus 4.00     0.32     0.50     0.60     22 

Champignon,    raised   in 

mushroom  beds 3.57     0.20     1.00     0.70     21 

In  spite  of  their  nitrogenous  compounds,  they 
possess  but  little  alimentary  value  and  serve 
generally  as  seasoning  only.  While  their  sa- 
vory qualities  provoke  gastric  secretion,  they  do 
not  agree  with  delicate  digestive  organs.  Xan- 
thic  bodies  are  plentiful,  and  toxic  elements  are 
present.  Hence  they  cannot  be  allowed  in  ar- 


GREEN   VEGETABLES  255 

thritis  and  similar  conditions,  neither  in  albumi- 
nuria,  nor  in  affections  of  the  heart. 

Fatal  accidents,  superinduced  by  the  inges- 
tion  of  poisonous  mushrooms,  are  so  frequent 
that  it  is  needless  to  dwell  on  them  here.  It 
is  often  very  difficult  to  distinguish  between 
edible  and  poisonous  mushrooms,  and  even  the 
good  ones  may  have  a  toxic  effect  on  predis- 
posed and  enfeebled  persons. 

If  truffles  do  not  in  every  instance  cause  poi- 
soning, they  nevertheless  fall  under  the  same 
restrictions  which  we  have  mentioned  before, 
especially  for  gouty  patients. 


FRUITS 

FRUIT  was  no  doubt  one  of  the  original  foods 
of  primitive  man,  and  even  now,  among  the 
ancient  races,  still  claims  the  place  of  honor. 
After  vegetarianism,  in  which  extensive  use  is 
made  of  it,  we  have  heard  a  good  deal  lately 
about  fruitarianism,  the  believers  in  which  pre- 
tend to  content  themselves  with  fruit  alone  as 
a  diet. 

We  will  not  enter  here  into  a  discussion  about 
the  specific  merits  of  these  two  doctrines,  but 
will  confine  ourselves  to  the  remark  that  we 
cheerfully  admit  the  excellent  value  of  these 
products  of  nature  as  a  proper  aliment;  also, 
that  with  the  qualities  possessed  by  them,  it  is 
quite  possible  to  correct  or  neutralize  the  evil 
effects  emanating  from  the  many  bad  habits 
that  taint  our  diet. 

It  would  be  a  matter  of  great  satisfaction,  in- 
deed, if  the  companies  and  trusts  that  are  inter- 
ested in  the  supply  of  fruits  were  to  arrange  the 

256 


FRUITS  257 

prices  so  as  to  enable  the  denizens  of  towns  and 
large  cities  to  use  them  more  freely. 

For  the  purposes  of  our  study  we  divide  the 
fruits  into  three  classes,  according  to  their  com- 
position and  different  characteristics,  viz. :  1, 
watery,  acidulated  fruits;  2,  those  that  contain 
sugar,  properly  speaking;  and  3,  amylaceous, 
or  oily  fruits. 

WATERY,   ACIDULATED    FRUITS 

COMPOSITION    AND    FOOD    VALUE 

Carbo- 
Albumin.      Fats.        hydrates.        Ash.  Calories. 

Apricots 0.81  0.11  13.74  0.44  61.00 

Cherries 0.95  0.67  16.31  0.41  77.00 

Lemons 0.33  0.33  9.62  0.26  44.00 

Quinces 0.94  0.62  25.00  0.35  113.00 

Strawberries 0.81  0.50  8.72  0.48  44.00 

Raspberries 0.67  0.93  13.39  0.38  62.50 

Gooseberries 0.68  0.48  13.14  0.55  61.50 

Oranges 0.51  0.22  11.38  0.34  51.00 

Peaches 0.77  0.43  14.18  0.43  65.50 

Apples 0.25  0.26  14.17  0.29  62.00 

Pears 0.43  0.26  14.50  0.32  62.00 

Plums 0.62  0.31  17.10  0.44  76.00 

Grapes 0.96  1.25  18.34  0.32  91.00 

It  is  obvious  from  these  data  that  water  rep- 
resents about  four-fifths  of  the  weight  of  this 


258  WHAT  SHALL   I    EAT? 

class  of  fruits,  to  which  is  due  their  refreshing 
nature  and  their  strong  power  to  quench  the 
thirst,  thus  acting  as  substitutes  for  tonic  bever- 
ages or  hard  and  soft  drinks. 

According  to  Pascault  the  water  contained  in 
fruit  possesses  particular  properties  and  enjoys 
a  special  vitality,  an  electric  reaction  analogous 
to  that  of  mineral  waters  when  taken  at  the 
springs. 

This  much  is  certain,  that  the  special  proper- 
ties of  fruits  rest  in  their  watery  contents. 

Albumin  and  fats  are  small  in  proportion. 
Fruits  are  the  least  nitrogenous  of  our  ali- 
ments. 

Carbohydrates  form  the  only  caloriferous 
principles.  A  little  more  abundant  than  in  the 
green  vegetables,  and  in  composition  less  varied, 
they  consist  almost  uniformly  of  glucose  and 
levulose  in  equal  parts,  and  a  small  percentage 
of  saccharose.  The  latter  is  diminished  in  pro- 
portion to  the  ripeness  of  the  fruit.  We  may 
add  a  small  compound  of  gum  and  of  pectic 
matter,  which  in  the  boiling  forms  the  jelly;  and 
of  ether,  to  which  the  fruits  owe  their  pleasant 
and  distinctive  aroma. 

Cellulose  is  very  lavishly  present,   averaging 


FRUITS  259 

often  one-twentieth  of  the  total  weight,  or  one- 
fourth  of  the  dry  extract. 

Free  acids  and  acid  salts  (malate,  citrate,  tar- 
trate,  fumarate)  are  plenteous,  whence  their 
real  acidity,  so  easily  discovered  by  the  taste,  is 
derived.  After  absorption  these  organic  acids 
are  burned  up  and  transformed  by  the  econo- 
my into  carbonates,  which  alkalize  the  juices. 
Hence  fruits,  when  being  ingested,  are  acid,  but 
in  the  process  of  assimilation  and  elimination 
become  alkaline.  On  account  of  the  small  per- 
centage of  ash  their  mineralizing  power  is  also 
very  small,  ranging  after  green  vegetables,  leg- 
umes, milk,  eggs,  and  certain  cereals;  but  pre- 
ceding meat,  fish,  bread,  pastry,  and  rice. 

Potassium  and  sodium  constitute  about  50  to 
60  per  cent  of  the  ash.  Phosphorus  is  wanting; 
lime  and  iron  are  a  little  stronger.  Sodium  chlo- 
rid  oscillates  between  0.01  and  0.02  per  cent. 

The  alimentary  value  is  naturally  low,  except 
in  grapes,  100  grams  of  which  will  give  100  ca- 
lories. The  merit  of  watery  acidulated  fruits 
is  to  be  found  in  the  high  percentage  of  water 
and  cellulose,  and  of  alkalinity. 


260  WHAT  SHALL   I    EAT? 

METHODS   OF   PREPARATION   AND   EMPLOYMENT 

Fresh,  natural  fruit  holds  its  laxative,  anti- 
scorbutic properties,  for  which  reason  it  is  best 
to  eat  it  in  that  condition.  But  it  should  be 
always  carefully  washed  and  peeled,  thereby 
removing  a  very  liberal  and  noxious  flora 
of  microorganisms.  Its  digestibility  depends 
largely  on  the  state  of  ripeness.  Immature 
pears  and  plums,  for  instance,  will  frequently 
cause  diarrhea  and  dysentery.  The  state  of 
preservation,  however,  is,  on  the  contrary,  a 
matter  of  secondary  consideration.  It  is  by  no 
means  an  established  fact,  that  mellow  pears, 
for  instance — that  is  to  say,  fruit  advanced  in 
age — is  worse  for  the  stomach  than  when  quite 
fresh. 

Cooked  fruit  is  very  easy  to  digest,  and  can  be 
eaten  to  advantage  by  a  large  number  of  dys- 
peptics. Peaches,  unpared,  just  steeped  for  two 
or  three  minutes  in  boiling  water,  form  an  ideal 
food  for  irritable  stomachs.  In  intermittent 
fever  a  fruit-broth  made  of  apples,  cherries, 
grapes,  bayberries,  and  prunes  is  most  effective 
and  beneficent.  Ewald  gives  the  following 
recipe: 


FRUITS  261 

"Pass  hot  gruel  through  a  strainer,  add  sliced 
plums  (or  any  other  fruit),  sugar,  and  a  pinch 
of  salt.  Boil  anew  until  the  fruit  becomes  ten- 
der." 

Fruit,  fresh  or  cooked,  does  not  keep  well. 
Although  hundreds  of  methods  and  means  for 
preventing  its  rapid  decay  have  been  advanced 
and  recommended,  none  has  so  far  given  the 
same  satisfaction  as  sterilization.  Put  the  fruit, 
either  with  or  without  sugar,  into  a  preserving- 
jar,  screw  the  lid  well  down  upon  the  rubber 
ring,  place  the  jar  for  one  quarter  of  an  hour  in 
boiling  water,  being  careful  not  to  let  the  water 
reach  the  cover  of  the  jar.  The  heat  will  ster- 
ilize the  fruit  completely.  As  the  air  in  the  jar 
cools  off  it  forms  a  vacuum,  and  hermetically 
seals  the  lid. 

The  prevailing  methods  of  preserving  fruits 
are  to  boil  them,  with  an  addition  of  sugar,  into 
a  jam  or  syrup,  which  is  kept  in  air-tight  jars 
or  bottles.  These  preparations  are  easy  enough 
to  digest,  and  the  large  content  of  sugar  in- 
creases the  nutritive  power;  but  they  incline  to 
provoke  gastric  or  intestinal  fermentation  and 
putrefaction.  Children,  particularly,  are  apt  to 
overeat  themselves  on  them  by  reason  of  the 


262  WHAT  SHALL   I    EAT? 

sweet  taste.  Proper  vigilance  in  their  diet,  as 
well  as  in  that  of  arthritics,  is  therefore  required. 
In  anorexia,  and  in  conditions  of  general  debility, 
they  serve  an  excellent  purpose.  Fruit  jellies, 
due,  as  we  have  already  said,  to  the  cooking 
of  the  pectic  contents  so  abundantly  present  in 
certain  fruits,  are  especially  easy  for  even  deli- 
cate stomachs.  Some  fruits  (apricots  and  pears) 
are  treated  by  a  process  called  desiccation, 
which  strongly  enhances  their  nutritive  power, 
as  the  percentage  of  water  falls  from  85  to  33, 
and  even  to  30. 

The  juices,  lemonades,  and  syrups  made  from 
fruit  are  all  to  be  recommended  to  the  healthy, 
as  well  as  for  generous  use  in  the  sick-room. 

REACTIONS 

a.  Digestive. — There  is  a  strong  resemblance 
here  to  the  green  vegetables,  as  has  already 
been  forecast  by  the  analysis.  The  action,  how- 
ever, is  twofold,  and  at  the  same  time  opposite. 
By  essence,  taste,  odor,  and  acidity  it  is  both 
physical  and  chemical,  which  gives  them  the 
quality  of  condiments  as  well  as  of  aperients; 
while  the  large  percentage  of  cellulose,  on  the 
other  hand,  retards  the  process  of  digestion,  and 


FRUITS  263 

even  may  irritate  the  stomach.  In  both  in- 
stances the  effect  is  more  pronounced  than  in 
the  legumes. 

The  same  similarity  may  be  observed  in  the 
intestinal  reaction.  Cellulose  here  again  acts, 
and  stimulates  peristalsis.  When  it  is  present 
to  excess,  or  when  the  fruit  is  ripe,  it  irritates 
and  ferments  and  engenders  diarrhea,  the  more 
so  if  the  canal  is  enfeebled  and  in  an  irritable 
condition. 

b.  General.  — Since  they  contain  nothing  of  a 
toxic  or  stimulating  nature,  being  composed  of 
salts  and  ternary  elements  only,  fruits  exercise 
the  beneficent  effects  of  a  cleansing,    elimina- 
ting,   and  disinfecting  character  on  the   whole 
organism,  this  being  entirely  due  to  the  high 
percentage   of  water   and    alkalines,  for  which 
reason  they  are,  as  it  were,  an  antidote  to  meat. 
Besides,  they  possess  a  special    antiuric  value. 
Not  only  do  they  dissolve  uric  acid,  but  they 
also  inhibit  its  formation.  —  (loteiko. ) 

This  reaction  pervades  the  whole  system,  but 
particularly  affects  the  circulation  and  the  liver, 
the  functions  of  which  are  largely  moderated 
by  it. 

c.  Renal. — The   kidneys  are   relieved  in  the 


264  WHAT  SHALL   I    EAT? 

same  proportion.  Elimination  through  them 
requires  no  exertion,  oxidation  is  accelerated, 
and  the  cellular  tissue  is  protected  from  deterio- 
ration. 

INDICATIONS   AND   CONTRAINDICATIONS 

Fruits  alkalize  the  fluids  of  the  body,  increase 
combustion,  disinfect  and  favor  elimination.  All 
these  properties  render  them  a  choice  food  in 
arthritis  which,  after  all,  is  only  a  state  of  hy- 
peracidity, with  small  powers  of  combustion  and 
elimination,  but  strongly  inclined  to  autointox- 
ication. Their  limited  nutritive  power  guards 
against  superalimentation,  and  the  cathartic 
efficacy  enhances  their  utility  in  every  division 
of  arthritis. 

Gouty  persons  had  better  beware  of  them, 
unless  intestinal  tolerance  has  been  well  estab- 
lished. 

In  uricemia  and  urinary  lithiasts,  likewise 
in  liver  complaints,  they  are  prohibited.  In 
chronic  rheumatism  their  use  should  be  re- 
stricted to  lemons  only. 

Diabetes  requires  special  consideration.  If 
fruits  are  alkaline,  and  if  their  carbohydrates 
consist  chiefly  of  levulose,  they,  nevertheless, 


FRUITS  265 

contain  a  large  quantity  of  glucose  and  saccha- 
rose, which  cannot,  as  is  the  case  in  green  vege- 
tables, be  eliminated  to  any  degree  by  cooking 
without  loss  of  taste  and  flavor.  The  best  ad- 
vice is  to  use  them  in  moderate  quantities,  with 
due  regard  to  the  percentage  of  sugar  and  the 
degree  of  tolerance  which  can  be  thus  tabulated: 

Bilberries,  whortleberries,  lemons,  gooseber- 
ries, oranges,  raspberries,  strawberries,  plums, 
peaches,  pears,  apples,  grapes,  quinces. 

It  is  well  to  remember  that  all  stone  fruits 
contain  the  smallest  amount  of  sugar  just  before 
they  are  entirely  ripe. 

In  acetonuria,  menace  of  coma,  fruits  contain- 
ing citric  and  acetic  acids  may  be  recommended 
without  hesitation,  as  they  contain  antiacetonic 
properties. 

Among  the  illnesses  in  which  a  fruit  diet  will 
prove  especially  beneficial  we  may  mention  ne- 
phritis, diseases  of  the  skin  (with  a  few  excep- 
tions), and  fevers.  In  all  these  cases  soups, 
broths,  and  juices  of  fruits  have  their  proper 
place,  above  all,  if  there  is  a  tendency  to  consti- 
pation, as  in  meningitis. 

Diseases  of  the  heart  and  of  the  blood-vessels 
may  just  as  well  be  added  to  this  list.  But,  if 


266  WHAT  SHALL   I    EAT? 

the  cardiac  muscles  are  enfeebled,  peeled  fruit 
cooked  or  in  the  form  of  jelly,  is  preferable,  be- 
cause it  puts  less  strain  upon  the  action  of  the 
heart  and  of  the  intestines.  In  atheroma,  fruits 
rich  in  citric  acid  must  be  prohibited,  because 
they  increase  the  chalky  deposit  in  the  tissues 
and  the  calcification  of  the  arteries.  —  (Loeper. ) 
For  the  same  reason  Ferrier  is  against  the  use 
of  oranges  and  lemons  in  pulmonary  tuberculosis. 

In  gastrointestinal  affections  it  is  difficult  to 
establish  a  fixed  rule,  and  extreme  caution  is 
required.  The  same  may  be  said  about  dyspep- 
sia, with  atony  of  old  standing;  likewise  about 
dilatations  with  putrefaction.  Some  cases  will 
tolerate  jams,  others  cooked  fruit  with  sugar, 
still  others  fresh  fruit,  eliminating,  however, 
such  as  are  too  acid  or  too  rich  in  cellulose. 

In  hyperchlorhydria  non-acid  and  thoroughly 
ripe  fruit  may  be  tolerated.  Similar  effects  will 
be  observed  in  anemia  and  dyspepsia,  on  account 
of  the  aperient  virtue  contained  in  fruit. 

In  intestinal  affections  fruit  must  be  forbidden 
whenever  there  is  exaggeration  of  peristalsis, 
irritation  or  inflammation  of  the  bowels.  It  is 
a  matter  of  common  knowledge  that  in  enteritis, 
and  in  all  cases  of  diarrhea,  the  use  of  fruit  will 


FRUITS  267 

cause  a  reappearance  of  the  symptoms;  but  this 
refers  only  to  raw  fruit;  when  cooked,  or  in 
the  shape  of  preserves,  the  juice  of  fresh  fruit 
does  not  fall  under  this  ban;  in  fact,  jelly  of 
quince  is  a  well-known  remedy  for  these  mal- 
adies. 

In  recent  years  some  exceptions  have  been 
made  in  this  direction;  for  instance,  cures  have 
been  effected  with  fruit  (banana-paste  or  straw- 
berries) in  cases  of  simple  serous  diarrhea,  so 
prevalent  at  times  in  hot  climates.  The  ban- 
ana-paste acts  through  the  antiputrefactive 
quality  of  its  carbohydrates.  The  action  of  the 
strawberries  is  as  yet  difficult  to  define. 

It  would  appear  reasonable  to  assume  that, 
inversely,  fruit  would  constitute  an  exceptionally 
strong  remedy  for  constipation.  But  the  prob- 
lem is  rather  complex,  for  we  must  not  lose 
sight  of  the  fact  that,  if  cellulose  affects  in- 
testinal peristalsis,  it  may  also  cause  fermen- 
tation and  aggravate  the  very  trouble  it  was 
intended  to  combat. 

In  simple  idiopathic  constipation  of  heavy  eat- 
ers, in  arthritis  and  persons  of  sedentary  habits, 
marvelous  results  will  often  follow  the  use  of 
fruits.  It  often  happens,  too,  that  with  the  cos- 


268  WHAT  SHALL   I    EAT? 

tiveness  the  hemorrhoids,  so  common  among 
this  class  of  patients,  disappear  also;  for  they 
regulate  peristalsis  and  circulation  alike. 

In  enterocolitis  they  are  not  so  well  borne,  and 
may  give  rise  to  irritation,  and  even  spasms.  If 
at  all,  they  should  only  be  administered  either 
cooked  or  as  preserves,  fresh  fruits  being  re- 
served for  light  attacks,  or  convalescence. 

If  constipation  is  due  to  atony  or  enteroptosis, 
much  prudence  is  required;  the  dilated  and  fa- 
tigued intestines  have  need  for  a  food  which 
leaves  less  residue — in  fact,  for  a  gastric  rather 
than  an  intestinal  diet;  and  all  fruits  belong 
decidedly  to  the  latter.  But,  if  used  at  all,  then 
only  when  absolutely  ripe  and  after  the  peel  or 
skin  and  all  the  seeds  or  stones  have  been  care- 
fully removed. 

Fruit  possesses,  moreover,  another  distinct 
advantage  of  great  social  import.  The  water 
which  it  carries  into  the  system  diminishes  the 
desire  for  drinking-water  and  alcoholic  bever- 
ages. Foster  has  proved  that  the  consumption 
of  alcohol  decreases  in  direct  ratio  to  the  in- 
creased consumption  of  fruits.  In  the  war 
against  alcohol,  which  is  so  conspicuously  be- 
ing waged  nowadays,  this  factor  should  play 


FRUITS  269 

a  prominent  role,  and  proper  means  should  be 
adopted  for  a  plentiful  and  cheap  supply  of  fresh 
fruits  among  the  masses. 

The  manufacture  of  non-alcoholic  wines  from 
grapes  is  a  step  in  the  right  direction.  Every 
effort  should  be  made  to  make  these  products 
more  and  more  popular. 

PARTICULARS 

Apricots  are  remarkable  for  their  high  acid- 
ity, which  restrains  their  use,  however.  But 
this  inconvenience  disappears  when  given  as 
preserves  or  compote. 

Wlwrtleberries,  bilberries,  and  cranberries  are 
highly  prized  for  their  astringent  and  antiseptic 
properties.  Combe  makes  large  use  of  them  in 
enter ocolitis.  As  preserves  they  render  excellent 
service  in  cases  of  gastrointestinal  embarrass- 
ments, chiefly  in  diarrhea. 

Pineapple  is  very  easy  to  digest.  It  is  very 
rich  in  cane-sugar. 

Cherries  possess  a  large  amount  of  cellulose, 
especially  in  the  skin,  which  cannot  be  removed. 
The  sick  should  only  eat  them  cooked.  Min- 
eral substances,  preferably  iron,  are  promi- 
nent. A  diet-drink  made  of  cherry-stems  has  a 


270  WHAT  SHALL   I    EAT? 

diuretic  effect  exactly  within  an  hour  after  con- 
sumption. Many  cases  of  gout  will  yield  to 
a  cherry  cure,  since  the  uric  acid  is  changed  into 
hippuric  acid;  but  a  constant  watch  must  be 
kept  for  the  appearance  of  symptoms  of  in- 
testinal trouble. 

Quinces  are  so  rich  in  cellulose  (they  contain 
three  times  as  much  as  cherries)  and  tannin,  that 
they  cannot  be  eaten  raw,  but  only  in  the  form 
of  marmalade,  jelly,  or  jam,  with  plenty  of 
sugar.  In  diarrhea,  especially  in  the  serous 
form,  they  act  as  an  astringent  and  a  tonic.  In 
the  normal  person  a  too  free  use  of  them  will 
bring  on  constipation. 

The  lemon  occupies,  among  the  fruits,  a  place 
of  its  own,  and  is  of  great  therapeutic  value. 
Citric  acid  is  refreshing  and  stomachic.  Lem- 
onade is  a  most  wholesome  drink,  and  withal 
most  popular.  Sucking  the  juice  of  a  lemon 
refreshes  the  system  in  a  marked  degree,  espe- 
cially on  hot  and  exhausting  days. 

For  dyspeptics  who  are  debarred  from  the  use 
of  spices,  vinegar,  and  aromatic  substances,  the 
lemon  furnishes  an  agreeable  and  hygienic  sea- 
soning, which  can  be  employed  in  a  hundred 
different  ways.  As  it  is  almost  entirely  devoid 


FRUITS  271 

of  carbohydrates,  diabetics  should  turn  to  it  with 
predilection. 

As  an  antirheumatic  it  deserves  special  atten- 
tion. In  acute  articular  rheumatism  it  is  of 
doubtful  value;  but  in  chronic  rheumatism  it  is 
an  unmixed  blessing.  The  diet  should  consist 
of  six  to  eight  lemons  a  day.  Stronger  doses 
are  apt  to  tire  the  stomach  and  to  favor  the  de- 
velopment of  arterial  atheroma  by  depriving 
the  tissues  of  their  chalky  constituents.  If  the 
latter  be  the  case,  the  lemon  must  be  eschewed, 
likewise  in  tuberculosis.  —  (Ferrier. ) 

We  must  here  call  attention  to  the  so-called 
antihydropic  virtues,  which  are  of  doubtful 
merit,  and  to  the  antiscorbutic  value,  which  is 
unquestionable.  In  Barlow's  disease  it  often 
suffices  to  add  a  few  drops  of  baby  food  in  order 
to  prevent  an  accident. 

Strawberries  contain  very  little  cellulose,  but 
masses  of  seeds  which  make  them  rather  hard  to 
digest  in  dyspepsia,  except  when  cooked  or  pre- 
served. As  the  sugar  content  is  relatively  low, 
diabetics  may  eat  them  in  fairly  large  doses. 
Of  all  the  acidulated,  aqueous  fruits  they  are 
the  most  highly  mineralized.  There  is  an  abun- 
dance of  sodium,  of  lime,  and  of  iron  (as  much  as 


272  WHAT  SHALL   I    EAT? 

in  lentils).  Hence,  they  are  a  splendid  food  for 
anemics  and  demineralized  persons.  The  straw- 
berry cure,  which,  according  to  Gruebler,  equals 
the  grape  cure,  is  of  particular  value  in  '  'pleth- 
ora, biliousness,  gravel,  and  gout. ' '  —  (Martinet. ) 

From  300  to  500  grams  is  the  standard  dose. 
In  certain  cases  of  chronic  diarrhea,  in  hot  cli- 
mates, two  to  three  pounds  of  fresh  strawberries 
per  day  should  be  prescribed. 

In  eczema,  urticaria,  and  in  all  skin  diseases 
they  are  forbidden,  because  they  contain  a  sali- 
cylic element  which  is  very  irritating. 

Raspberries  are  inferior  to  strawberries,  inas- 
much as  they  contain  three  times  the  amount  of 
cellulose  and  less  ash.  Gruebler  claims  for  them 
antihemorrhagic  properties. 

Gooseberries  are  extremely  aqueous  (93  per 
cent  of  water  to  the  pound).  The  taste  is 
strongly  acid  (citric).  The  abundance  of  skin 
and  seeds  makes  them  heavy  and  irritating  to 
the  stomach  and  the  intestines.  But  in  the 
shape  of  jam  or  jelly  they  are  excellent.  They 
contain  only  4  per  cent  of  sugar,  hence  should 
be  the  favorite  fruit  of  diabetics. 

Mandarins  are  almost  identical  in  composi- 
tion with  the  orange,  but  approach  the  lemon 


FRUITS  273 

more  than  the  latter,  being  richer  in  citric  acid 
and  poorer  in  sugar.  They  share  also  the  same 
good  and  bad  qualities,  although  in  a  smaller 
degree. 

The  juice  of  the  orange  possesses  a  strongly 
marked  flavor,  and  is  often  used  for  masking 
the  taste  of  castor-oil. 

The  Peach  is  one  of  the  choicest,  most  deli- 
cately flavored  fruits;  but,  being  rather  rich  in 
cellulose,  dyspeptics  should  not  partake  of  them 
except  as  compote,  or  when  cooked  in  the 
skin. 

Pears  are  a  heavy  food,  rich  in  cellulose  and 
hard  for  delicate  stomachs,  unless  they  are 
cooked.  Dried  pears  have  a  high  nutritive 
value,  257  calories  in  100  grams. 

Apples  show  the  same  disadvantage.  The  per- 
centage of  magnesium  is  double  that  of  lime, 
for  which  reason  they  suit  patients  suffering 
from  oxaluria.  Certain  authorities  claim  anti- 
uric  properties  for  them  which  should  prove  use- 
ful in  gout  Weiss  maintains  that  the  apple 
only  reacts  when  eaten  with  the  skin,  on  ac- 
count of  the  picric  acid  present  therein. 

Plums  and  prunes  are  of  slow  digestion  and 
often  the  cause  of  diarrhea.  Dried  prunes  are 


274  WHAT  SHALL   I    EAT? 

a  good  remedy  for  constipation.  Prunes  with 
senna  are  a  mild  purgative,  and  worthy  of  rec- 
ommendation. 

Peaches,  pears,  apples,  plums,  and  prunes  con- 
tain malic  acid.  Sugar  is  bounteous  enough  to 
exclude  them  from  the  table  of  the  diabetic. 

Grapes  reach  the  highest  zone  of  all  the  prop- 
erties recognized  in  fruit,  generally  speaking, 
for  which  reason  they  are  preferred  in  medicine 
for  the  purposes  of  cure.  The  percentage  of 
acidity  is  moderate,  but  varies  somewhat  in  the 
different  species.  It  decreases  with  the  age  of 
the  grape  in  the  same  ratio  in  which  sugar  in- 
creases. The  latter  is  nearly  all  glucose,  and 
exceeds  in  quantity  that  of  any  other  fruit. 
Saccharose,  dulcite,  and  mannite  are  but  slight- 
ly represented. 

If  ingested  in  small  portions  only,  grapes 
agree  with  almost  every  kind  of  illness,  but  it  is 
necessary  to  warn  the  patients,  especially  those 
suffering  from  indigestion  or  enter ocolitis,  to  care- 
fully spit  out  the  skin  and  pips.  We  make  two 
exceptions  here:  diabetes,  on  account  of  the 
prevalence  of  glucose,  and  diarrhea,  on  account 
of  their  laxative  action. 

The  indications  for  a  true  grape  cure,  which 


FRUITS  275 

consists  in  the  consumption  of  from  two  to  four 
pounds  of  grapes  a  day  with  a  corresponding  re- 
duction of  other  foodstuffs,  are  naturally  very 
limited.  It  is  largely  practised  around  the  Lake 
of  Geneva,  but  can  be  undertaken  anywhere 
with  well-matured  and  mellow  grapes. 

The  following  rules  are  generally  observed: 
One-half  the  quantity  prescribed  is  taken 
about  noon,  an  hour  or  so  before  luncheon,  one- 
fourth  an  hour  after  luncheon,  and  the  last  one- 
fourth  an  hour  after  the  evening  meal.  Cer- 
tain precautions  must  be  observed,  if  this  large 
volume  of  food  is  to  be  well  tolerated.  1.  The 
grapes  must  not  be  eaten  too  cold;  2,  they 
must  be  previously  washed  to  remove  the  sulphate 
of  copper  coating;  3,  they  must  be  eaten  very 
slowly  and  thoroughly  masticated,  skin  and  pips 
being  carefully  rejected;  4,  after  each  dose 
physical  exercise  must  be  taken;  5,  moreover,  it 
is  wise  to  begin  with  a  smaller  dose,  say  one 
pound  per  day,  which  can  be  easily  increased 
until  the  maximum  of  four  pounds  has  been 
reached.  Since  four  pounds  of  grapes  represent 
about  1,800  calories,  the  necessity  of  reducing 
very  materially  the  rest  of  the  diet  will  be  ap- 
parent. Haussmann  suggests  total  abstention 


276  WHAT  SHALL   I    EAT? 

from  beer,  meat,  fatty  fish,  salads,   and  coarse 
bread  during  the  cure. 

The  following  symptoms  should  be  carefully 
watched:  Stomatitis  caused  by  the  hyperacid- 
ity of  the  grapes,  attacks  of  dyspepsia  and  of 
diarrhea.  If  any  of  these  should  manifest  them- 
selves, the  daily  ration  should  be  reduced.  It 
very  rarely  becomes  necessary,  however,  to  in- 
terrupt the  cure  altogether  on  account  of  any  of 
these  events. 

This  diet  at  once  involves  the  intestines,  the 
liver,  the  kidneys,  and  nutrition  in  general. 
Hence,  the  indications  can  be  given  with  pre- 
cision. As  the  action  on  the  bowels  is  loosening, 
the  cure  is  effective  in  constipation.  Especially 
in  people  of  sedentary  habits,  in  superalimenta- 
tion  and  abdominal  plethora.  Hemorrhoids  rap- 
idly improve  under  it,  but  only  when  stomach 
and  intestines  are  robust  and  vigorous.  The 
liver  experiences  an  excitation  like  to  the  cut  of 
a  whip,  which  stimulates  all  its  functions,  espe- 
cially the  bile  secretion.  In  lithiasis  and  hepatic 
congestion,  unless  complicated  with  alimentary 
glycosuria,  it  proves  of  much  benefit. 

The  urine  becomes  more  abundant,  more  al- 
kaline, but  poorer  in  uric  acid  under  this  treat- 


FRUITS  277 

ment,  which  produces  also  very  happy  results  in 
uricemia,  gall-stones,  in  chronic  catarrhs  of  the 
bladder,  especially  of  old  standing.  But  the 
digestive  avenues  must  be  clear  and  in  good 
condition. 

The  intraorganic  combustion  is  markedly  ac- 
celerated by  reason  of  the  steadily  increasing 
alkalinity  of  the  somatic  humors;  in  fact,  a 
grape  cure  constitutes  a  veritable  irrigation,  a 
lixiviation,  so  to  speak,  of  the  whole  organism, 
especially  in  slow  and  toxic  arthritis.  Whether 
it  has  an  economic  reaction  on  the  nitrogenous 
bodies,  on  the  fats  and  carbohydrates,  is  rather 
doubtful.  We  do  not  think  that  a  cure  of  this 
kind  can  have  the  least  beneficial  effect  on 
tuberculosis. 

Raisins  (dried  grapes)  show  a  heavy  loss  of 
water  and  free  acids  which,  of  course,  increases 
the  percentage  of  sugar.  They  are  hard  to  di- 
gest, and  unfit  for  delicate  stomachs  and  intes- 
tines. 


278  WHAT   SHALL   I    EAT? 

SACCHARINE   AND   NEUTRAL   FRUITS 

Carbo- 
Albumin.         Fats.  hydrates.          Ash.         Calories. 

Bananas 1.21  0.50  21.87  0.65  100 

Dates 1.60  0.80  71.61  1.23  308 

Figs  (fresh)  ...  1.12  0.24  18.09  0.43  81 

Figs  (dried)  ...  2.89  1.22  61.52  2.09  276 

These  varieties  of  fruit  form  an  homogeneous 
class,  possessing  the  following  characteristics, 
viz. :  absence  of  acids,  which  gives  them  a  pecul- 
iarly sweetish  taste,  a  very  high  percentage  of 
sugar,  especially  when  dried  or  half  dry;  and  a 
fairly  high  nutritive  value,  which  is  due  almost 
entirely  to  their  carbohydrates;  but  a  feeble 
mineralization,  with  potassium  and  sodium  pre- 
dominating. 

They  form  staple  foods  for  certain  tribes  in 
Asia  and  Africa  and  the  West  Indies,  and  are 
an  important  food  factor  also  in  the  United 
States  and  certain  parts  of  Europe.  Their  anti- 
costive  qualities  (especially  of  figs)  render  them 
particularly  valuable. 

Of  course,  in  diabetes  and  dyspepsia  of  the 
stomach  or  of  the  bowels,  they  have  no  place, 
being  much  too  hard  to  digest.  Bananas  may 
be  excepted  if  made  into  a  compote  with  plenty 


FRUITS  279 

of  sugar  and  passed  through  a  fine  strainer,  in 
which  form  they  make  a  very  nourishing  dish, 
equally  easy  for  the  stomach  and  the  canal  of 
the  confirmed  dyspeptic.  —  (H.  Labbe.)  Figs 
and  dates  are  emollient  fruits. 

OILY   FRUITS 

Carbo- 
Albumin.         Fats.         hydrates.        Ash.  Calories. 

Almonds  (dry) 17.60  49.00  17.00  1.60  605 

Hazlenuts  (Filberts)  13.50  56.00  12.17  1.91  636 

Walnuts  (dry) 14.06  52.06  15.48  1.24  619 

Olives  (green) 0.83  18.40  8.80  1.10  213 

We  might  as  well  eliminate  olives  as  a  food- 
stuff, for  they  are  used  chiefly  as  a  condiment,  or 
savory  only,  and  are  very  hard  to  digest.  Their 
best  quality  is  to  be  found  in  the  oil  which  is 
gained  from  them,  and  of  which  we  have  al- 
ready spoken. 

The  other  fruits,  however,  belonging  to  this 
category  are  an  exceptionally  valuable  nutritive 
coefficient  by  reason  of  their  very  high  nitroge- 
nous components.  With  the  exception  of  butter, 
oil,  and  animal  fats,  they  leave  the  other  foods 
far  behind,  surpassing  in  nutritive  power  even 
cheese  and  beans  by  one-third.  The  great 
drawback  is  their  indigestibility,  especially  when 


280  WHAT  SHALL   I    EAT? 

eaten  in  large  quantities.  They  represent  sim- 
ply a  lump  of  cellulose,  abundant  and  compact, 
which  makes  them,  despite  the  most  careful 
mastication,  a  rather  tough  proposition  even  for 
robust  stomachs,  and  quickly  provokes  that  feel- 
ing of  fulness  and  satiety  characteristic  of  nuts. 
Even  inveterate  vegetarians  are  beginning  to 
recognize  this  fact  and  to  use  them  only  when 
finely  grated.  Upon  arriving  in  the  bowels 
their  action  is  doubly  laxative,  owing  to  a  sur- 
charge of  cellulose  and  oleaginous  principles. 
We  take  leave  to  point  out  the  larger  percentage 
of  nitrogen  and  the  complete  absence  of  xanthic 
bodies.  Also,  that,  like  cheese,  they  furnish  a 
considerable  reserve  of  albumin  quite  free  from 
purins. 

Generally  speaking,  they  are  fit  enough  for 
robust  and  healthy  constitutions,  quite  suitable 
for  navvies  and  persons  engaged  in  manual  labor 
or  dwelling  in  frigid  zones. 

In  pathological  conditions  their  use  is  very  lim- 
ited, and  almost  exclusively  restricted  to  diabet- 
ics, for  whom  they  form — being  both  nutritive 
and  almost  free  of  sugar — an  ideal  substitute  for 
bread.  The  * '  almond  breads, ' '  however,  sold  in 
the  market,  are  too  heavy  and  too  solid,  apart 


FRUITS  281 

from  having  a  disagreeable  taste  and  being  very 
indigestible.  We  prefer  the  almond  cakes  pre- 
pared after  de  Goff's  formula,  viz. :  250  grams 
of  shelled  sweet  almonds  are  pulverized  in  a 
mortar,  2  eggs  are  added,  together  with  2  grams 
of  bicarbonate  of  soda  and  1  gram  of  tartaric 
acid.  Triturate  and  mix  carefully.  Pour  the 
paste  into  a  mold  and  cook  for  twenty-five  min- 
utes. This  will  make  a  cake  weighing  300 
grams,  sufficient  for  one  meal  and  containing 
only  5  to  7  per  cent  of  carbohydrates. 

Dyspeptics  should  shun  all  these  fruits  the 
same  as  any  other  indigestible  food.  In  ar- 
thritis and  obesity  they  had  better  be  forgotten, 
for  they  are  too  replete  with  nutriment. 


CONDIMENTS 

UNDER  this  name  we  comprise  a  number  of 
substances  of  spicy  taste  which  are  added  to  our 
foods  for  the  purpose  of  either  changing  or  im- 
proving their  flavor.  They  form  the  most 
important  basis  of  what  we  call  "the  kitchen," 
and  to  them  are  due,  in  a  large  measure,  all  the 
advantages,  as  well  as  the  inconveniences,  of  our 
cooked  foods.  For,  if  dispensed  without  reason 
and  judgment,  with  a  free  hand  as  it  were,  they 
do  harm;  but,  if  employed  in  moderate  quanti- 
ties, they  serve  a  useful  purpose,  and  in  some 
instances  become  even  a  matter  of  necessity. 

The  advantages  of  condiments  are  in  favor  of 
digestion.  Most  of  them  appear  to  stimulate 
the  action  of  the  stomach  and  of  the  intestines 
by  direct  chemical  action;  although  this  is 
doubted  by  some  and  absolutely  decried  by 
other  authorities.  At  any  rate  they  seem  apt 
to  provoke  a  certain  amount  of  irritation. 
Nevertheless,  we  must  admit  that  they  sharpen 
the  appetite  by  adding  zest  to  the  dish  and  thus 

282 


CONDIMENTS  283 

exciting  the  psychic  secretions,  the  importance 
of  which  has  been  demonstrated  by  Pauloft's 
researches.  In  this,  no  doubt,  consists  the  sum 
total  of  their  utility,  which  is  chiefly  of  an  anti- 
septic nature,  indirectly  stimulating  the  normal 
secretions,  and  directly  acting  by  their  essential 
oils  (salt,  garlic,  mustard,  etc. ). 

They  may  be  looked  upon  as  agents  of  as- 
similation and  economy,  though,  with  the  ex- 
ception of  salt,  this  is  a  matter  of  secondary 
consideration. 

Most  of  the  condiments  are  not  foods  in  the 
strict  sense  of  the  word,  inasmuch  as  they  do 
not  cover  our  needs  of  energy  or  of  mineral 
principles.  We  except  salt  and  sugar,  the  for- 
mer being  indispensable  for  maintaining  our 
mineral  equilibrium,  and  the  latter  being  the 
most  useful  factor  in  the  production  of  mus- 
cular force. 

SALT 

Sodium  chlorid  forms  the  chief  constituent, 
and  is  accompanied  by  certain  very  valuable  im- 
purities, such  as  bromid,  iodid,  arsenic,  and 
fluor.  The  composition  of  the  salt  gained  from 
saline  waters  differs  but  little  from  that  of  the 


284  WHAT  SHALL   I    EAT? 

rock  salt  taken  from  mines.  Both  undergo  con- 
siderable changes  in  the  process  of  refining. 
The  fine  table  salt  contains  less  iron  and  arsenic 
than  the  coarser  kitchen  salt,  and  for  that  rea- 
son is  perhaps  less  hygienic.  Sea  salt  particu- 
larly excites  the  gastric  secretions. 

Sodium  chlorid  is  the  one  mineral  principle 
in  which  nearly  all  our  foodstuffs  are  deficient, 
and  has  to  be  added  at  the  rate  of  from  6  to  8 
grams  to  our  daily  rations. 

Recent  research  seems  to  have  proved  to  satis- 
faction that  the  hydrochloric  acid  of  the  gastric 
juices  is  principally  derived  from  the  sodium 
chlorid  ingested  with  our  food,  and  not  from 
the  salt  contained  in  our  blood.  Salt  is,  there- 
fore, an  essential  condition  for  this  secretion. 
For  the  bowels  it  is  of  smaller  importance,  but 
it  maintains  equality  of  tension  of  the  blood 
(isotonia).  If  taken  in  overlarge  quantities  it 
provokes  hypersecretion  and  diarrhea. 

The  effect  of  salt  on  the  nutrition  is  consider- 
able. It  contributes  much  to  the  stability  of 
vascular  pressure  and  the  general  tone  of  the 
organism,  and  facilitates  the  changes  in  the 
tunica  intima.  The  small  molecules  of  sodium 
chlorid  are,  so  to  speak,  the  small  change  which 


CONDIMENTS  285 

serves  as  a  medium  between  the  double  cur- 
rency passing  from  the  cellular  tissue  to  the 
plasma,  and  vice  versa  from  the  plasma  to  the 
cells.  It  exercises  over  the  process  of  nutrition 
an  influence  of  economy  and  moderates  the 
movement  of  nitrogenous  disassimilation,  bring- 
ing about  at  the  same  time  the  oxidation  of  the 
unassimilated  substances  (coefficient  of  oxida- 
tion). 

Some  authorities  invest  it  also  with  the  power 
of  forming  hemoglobin  and  red  blood  corpuscles. 

For  all  these  reasons,  sodium  chlorid,  the  pro- 
tector of  the  isotonia  of  our  body  fluids,  should 
be  kept  on  a  steady  level  within  our  economy. 
Bunge  goes  so  far  as  to  claim  that  this  cannot 
be  accomplished  except  by  the  absorption  of  a 
stated  daily  ration.  In  effect,  our  daily  food, 
especially  the  vegetables,  -carries  into  our  system 
a  notable  amount  of  the  salt  of  potassium,  which 
splits  the  sodium  chlorid  into  potassium  chlorid 
and  sodium  phosphate,  both  of  which  are  elim- 
inated like  foreign  bodies,  thus  establishing  a 
serious  loss  in  sodium  chlorid  which  it  should 
be  the  task  of  alimentation  to  supply. 

Salt  is  also  an  important  factor  in  the  rena] 
secretions.  Not  only  does  it  augment  the  aque- 


286  WHAT  SHALL   I    EAT? 

ous  diuresis,  but  also  the  solid  residue.  Sodium 
chlorid  is  the  active  means  ' '  by  which  the  kid- 
neys eliminate  the  greater  portion  of  unassim- 
ilated  substances,  such  as  urea,  the  complex 
amins,  the  leucomains,  etc.,  and  the  glucose  in 
diabetes,  no  matter  whether  these  bodies  form  a 
direct  union  with  the  salt  or  whether  the  prod- 
ucts of  decomposition  of  the  tissues  are  disin- 
tegrated and  carried  off  by  the  sodium,  such  as 
the  biliary  acids  and  the  original  sodium  of  the 
salt  itself ." l 

This  discussion  would  be  incomplete  if  we 
were  to  neglect  to  make  proper  mention  of  the 
injuries  done  by  the  accumulation  of  salt  in  our 
tissues.  Archaud  and  Loeper,  and  Widal  and 
Javal,  have  dealt  exhaustively  with  the  fre- 
quency of  its  occurrence,  which  often  favors  the 
formation  of  oedemata  that  infiltrate  the  whole 
cellular  tissue  and  the  serous  cavities,  and  final- 
ly involve  the  canal  and  the  process  of  nutri- 
tion itself.  In  rare  cases  the  retention  of  chlorid 
is  dry,  causing  hypertension  and  cardiac  fatigue, 
as  well  as  sluggishness  of  the  pulse.  —  (Enriquez 
and  Ambard. ) 

In  both  conditions  the  renal  functions  are  af- 


'A.  Gautier,  loc.  cit.,  p.  386. 


CONDIMENTS  287 

fected,  and  it  is  quite  true  that,  if  the  normal 
kidney  requires  salt  for  normal  action,  salt  is 
poison  to  the  pathological  kidney,  involving 
proportionate  serious  damage.  For  the  healthy 
person  salt  is  a  necessary  adjunct,  the  more  so  if 
vegetables  form  a  large  item  of  the  diet.  The 
only  tribes  (Tounguses  and  Ostiacs)  known  to 
eschew  it,  live  almost  exclusively  on  meat. 

Too  much  salt  is  injurious.  Diseases  such  as 
nephritis  follow  in  its  wake.  In  some  diseases  it 
is  permissible  to  force  the  daily  allowance  a  lit- 
tle; for  instance,  in  tuberculosis,  scrofula,  and 
lymphangitis,  in  dyspepsia  from  insufficiency,  and 
in  hyperchlorhydria.  According  to  von  Noor- 
den  salt  will  serve  a  good  purpose  in  gouty 
affections  by  speeding  the  solution  of  uric  acid. 

A  dechlorhydrated  regimen  is  indicated  in 
a  number  of  cases.  In  nephritis,  especially  in 
cedematous  nephritis,  it  has  been  adopted  by 
Widal  with  gratifying  results.  It  often  brings 
about  a  rapid  resorption  of  osdematous  growths, 
and  permits  of  constant  changes  in  the  diet  of 
the  patient  by  varying  slightly  salted  with 
unsalted  dishes.  In  dry  nephritis  with  hyperten- 
sion, improvement  is  less  marked,  as  the  reten- 
tion of  chlorin  is  smaller. 


288  WHAT  SHALL   I    EAT? 

Nevertheless,  it  is  always  advisable  to  give  it 
a  trial.  To  judge  from  these  facts,  a  dechlorhy- 
drated  regimen  ought  to  prove  efficacious  in  scar- 
latina, as  the  advantage  of  a  varied  diet  ought 
to  forestall  renal  complications.  The  question, 
we  think,  deserves  further  study. 

These  reflections  should  encourage  us  in 
adopting  the  same  regimen  in  dropsy,  in  cardiac 
diseases,  in  hepatic  affections  with  ascitis,  and 
also  in  infectious  phlebitis.  —  (Chantemesse.)  In 
the  first  two  cases  it  has  proved  useful,  although 
not  curative.  In  the  latter  case  the  results  are 
uncertain.  The  same  observation  has  been 
made  in  arterial  hypertension,  hyperchlorhydria, 
and  in  obesity  (Labbe),  in  all  of  which  the  effect 
has  been  of  unequal  value,  causing  anemia,  ano- 
rexia, emaciation,  and  inadequate  nutrition. 

SUGAR 

We  shall  deal  here  only  with  saccharose,  or 
cane-sugar,  such  as  is  ordinarily  employed  in 
every  household.  This  is  a  disaccharid,  which 
splits  into  glucose  and  levulose.  The  consump- 
tion of  sugar  has  attained  enormous  proportions 
in  all  civilized  countries;  and,  from  the  hygienic 
standpoint,  is  an  important  factor  in  our  bill 


CONDIMENTS  289 

of  fare.  As  a  condiment  sugar  stimulates  the 
appetite,  for  which  reason  it  seems  to  appeal 
strongly  to  frail  constitutions.  To  children  it 
should  be  given  in  moderate  quantities  only,  as 
they  rather  require  a  given  proportion  of  salty 
foods.  Only  a  little  of  it  is  retained  by  the  stom- 
ach, although  its  sweetness  flatters  the  palate. 
In  the  bowels  it  is  dissected  by  the  acids  of  the 
intestinal  juices  and  absorbed  in  toto,  without 
leaving  a  residue,  thus  favoring  constipation. 
In  concentrated  solutions  it  is  prone  to  irritate 
the  gastric  mucous  membrane,  and,  if  eaten  in 
overlarge  quantities,  it  may  give  rise  to  an  acid 
fermentation  along  the  whole  of  the  gastrointes- 
tinal tract.  When  once  it  has  entered  the  gen- 
eral circulation,  it  infiltrates  the  hepatic  cellular 
tissue,  and  is  warehoused  there  in  the  form  of 
glycogen. 

Combustibility  bestows  upon  it  a  calorific 
value,  almost  equal  to  that  of  albumin;  but,  as 
the  organism  utilizes  only  the  glucose,  no  chem- 
ical changes  take  place,  for  which  reason  it  may 
be  considered  superior  to  starch,  which  requires  a 
much  more  thorough  digestion.  Its  isodynamic 
coefficient  is  397  calories  per  100  grams. 

An  attempt  has  been  made  to  attribute  to 


290  WHAT  SHALL   I    EAT? 

sugar  a  diuretic  action;  but,  whatever  there  is 
of  it,  is  rather  feeble  and  indirect  and  provoked 
by  means  of  hepatic  excitation.  Beet  sugar  is 
an  excellent  food  for  healthy  persons,  especially 
those  engaged  in  manual  labor.  The  working- 
man  will  derive  from  it  as  much  or  even  more 
power  than  from  meat;  besides,  it  is  less  expen- 
sive and  less  noxious.  Experiments  made  on 
horses  and  men  have  proved  sugar  to  be  of  great 
value  when  strenuous  and  prolonged  physical 
efforts  were  demanded. 

Troops  also,  engaged  in  fatiguing  field  exer- 
cises, are  said  to  have  been  much  benefited  by  a 
generous  sugar  diet. 

As  a  fattening  medium  it  possesses  undoubted 
merit  and  should  be  recommended  to  all  who 
are  under  the  necessity  of  keeping  their  physical 
reserves  in  special  repair,  especially  when  the 
appetite  requires  a  stimulating  agent.  But  we 
warn  against  excessive  use,  for  fear  of  consequent 
fermentations. 

Patients  suffering  from  gastric  or  intestinal 
putrefaction  in  atony,  stasis,  or  gastrecstasis,  or 
from  skin  diseases,  especially  acne  and  furuncu- 
losis,  should  heed  this  advice.  In  arthritis  sugar 
often  becomes  a  factor  of  superalimentation.  In 


CONDIMENTS  291 

obesity  and  liver  complaints  extreme  caution  is 
indicated.  In  gout  it  only  proves  dangerous 
when  eaten  together  with  meat,  in  which  case 
the  acid  fermentations  impede  the  elimination 
of  the  uric  acid,  whilst  a  vegetable  diet  has  the 
opposite  effect.  —  (loteiko. ) 

It  goes  without  saying  that  in  diabetes  it  is 
interdicted.  To  meet  the  hardships  coupled 
with  this  absolute  prohibition,  certain  substi- 
tutes are  manufactured  nowadays  which,  though 
they  possess  the  taste  of  sweetness,  yet  are  de- 
void of  all  the  inconveniences  attributable  to 
sugar.  Foremost  among  them  are  saccharine 
(benzoic  sulphinide  acid)  which  is  quite  harmless 
and  two  hundred  and  forty  times  as  sweet  as 
cane-sugar;  and  dulcine  (paraphenol-carbamid), 
two  hundred  times  as  sweet  as  cane-sugar,  but 
of  which  not  more  than  50  centigrams  per  day 
may  be  consumed  with  safety.  —  ( Von  Noorden. ) 

In  former  days  honey  was  more  in  common 
use,  in  the  pharmacy  as  well  as  in  the  kitchen, 
when  the  price  of  sugar  was  so  much  higher  than 
it  is  to-day.  It  consists  of  almost  equal  parts  of 
glucose  and  levulose,  with  a  small  percentage  of 
saccharose  and  some  aromatic  substances  and 
coloring  matter.  The  available  calories  are  230 


292  WHAT  SHALL   I    EAT? 

in  100  grams.  On  account  of  a  slight  prepon- 
derance of  levulose  it  proves  to  be  harder  on 
diabetics  than  cane-sugar.  But  its  laxative  and 
antifermenting  properties  render  it  excellent  in 
food  value.  As  a  purgative  for  children  of  ten- 
der age  it  is  admirable. 

OTHER   CONDIMENTS 

In  the  kitchen  a  whole  series  of  substances  are 
employed  which  have  been  styled  by  Gautier  as, 
1,  aromatic  condiments,  i.e.,  vanilla,  cinnamon, 
cloves,  chevril,  parsley,  bay-leaf,  etc. ;  2,  acrid 
or  peppery:  common  peppercorn,  ginger,  all- 
spice; 3,  alliaceous  or  allylic:  onion,  mustard, 
horseradish;  4,  add:  vinegar,  capers,  gherkins, 
citron;  5,  condiments  of  animal  origin:  ancho- 
vies, caviar. 

Their  food  value  is  either  nil  or  exceedingly 
small,  yet  they  possess  properties  of  which  we 
have  already  spoken.  They  stimulate  the  appe- 
tite, and  consequently  the  digestive  functions; 
their  action  is  antiseptic,  especially  the  aromatic 
species,  such  as  garlic  and  mustard.  In  the 
summer-time  and  in  hot  climates  these  condi- 
ments serve  the  purpose  of  rousing  the  torpid 
and  sluggish  digestive  organs  into  useful  activ- 


CONDIMENTS  293 

ity,  whilst  among  the  poorer  classes  they  aid  in 
disguising  dishes  of  doubtful  freshness,  and  pre- 
vent accidents. 

In  certain  diseases  they  may  be  employed 
with  advantage. 

In  diabetes  they  help  to  digest  the  fats;  in 
chronic  gastritis  and  in  major  atonies  their  stim- 
ulating and  antiseptic  virtues  need  not  be 
feared.  The  same  is  true  in  chronic  fevers  and 
in  tuberculosis.  For  this  reason,  especially  in 
the  summer  months,  the  "hors  d'reuvres, "  or 
savories,  are  useful  in  anorexic  tuberculosis. 

Special  mention  may  be  made  here  of  caviar 
by  reason  of  its  strongly  marked  lecithin  phos- 
phorous content. 

It  is  well  to  bear  in  mind,  however,  that  these 
condiments,  when  taken  in  small  doses,  are 
wholesome,  but  soon  become  noxious  when  in- 
gested in  large  portions,  because  they  force 
superalimentation,  because  their  violent  stimu- 
lation is  superseded  by  a  phase  of  corresponding 
depression,  and  because  they  irritate  too  much 
the  whole  digestive  system — the  stomach,  the 
bowels,  the  liver,  and  the  organs  of  elimination. 

As  too  irritating  and  therefore  ever  to  be 
avoided,  we  quote:  red  pepper,  ginger,  allspice, 


294  WHAT  SHALL   I    EAT? 

red  cabbage,  and  all  varieties  of  sauces  and 
pickles,  whether  of  English  or  American  ori- 
gin. Among  the  less  irritating,  which  may  be 
taken  with  impunity  but  in  moderate  amounts, 
we  enumerate:  garlic,  onions,  capers,  gherkins, 
mustard,  ordinary  black  and  white  pepper, 
cloves,  and  vinegar.  The  others  are  harmless. 

Certain  morbid  conditions  are  contraindica- 
tions: hyperchlorhydria,  inflammation  of  the 
stomach  or  of  the  intestines,  hemorrhoids,  athe- 
roma,  kidney  disease,  cystitis,  blennorrhagia,  skin 
diseases,  liver  complaints,  cirrhosis,  lithiasis, 
jaundice — in  all  of  which  pepper  and  allspice  are 
specially  harmful,  as  has  been  proved  to  satis- 
faction by  long  experience. 


NERVE  FOODS 

THE  term  "nerve  foods"  is  justifiable  only  in 
part;  for,  although  the  substances  to  which  it 
refers  primarily  exert  a  stimulating  influence  on 
the  nervous  system,  their  value  as  a  food  is, 
with  the  exception  of  cocoa,  almost  nil.  We  are 
tempted  to  include  them  rather  in  the  name  of 
medicaments  than  of  foods.  But,  since  they 
form  a  part  of  the  daily  nutriment  of  the  nor- 
mal individual,  we  will  give  them  due  consider- 
ation here  under  the  title  of  nerve  foods. 

COFFEE 

It  is  used  in  all  civilized  countries  to  a  large 
extent;  and,  we  are  afraid,  often  too  freely.  The 
berries  of  the  coffee-tree  are  dried  in  the  sun 
and  come  on  the  market  in  the  shape  of  green 
beans.  Roasting  frees  the  essential  oils,  devel- 
ops the  aroma,  and  produces  a  partial  carameli- 
zation.  The  roasted  beans,  when  ground  in  a 
coffee-mill,  are  ready  for  infusion. 

295 


296  WHAT  SHALL   I    EAT? 

It  is  needless  to  give  a  quantitative  analysis, 
as  coffee  possesses  no  alimentary  value.  Besides 
some  nitrogenous  matter,  cellulose,  sugar  and 
dextrin,  aromatic  oils  and  fatty  substances,  and 
a  few  mineral  bodies,  among  which  potassium 
phosphate  predominates,  its  essential  principle  is 
caffein,  partially  combined  with  a  certain  tannic 
acid  (caffeotannic  acid),  which  gives  the  coffee 
a  slightly  antiseptic  property.  Caffein  is  a  tri- 
methyl  xanthin,  and  is  closely  related  to  xan- 
thin,  uric  acid,  and  the  purin  bodies.  The 
absorption  of  coffee  increases,  therefore,  the  pro- 
duction of  urinary  uric  acid. 

A  cup  of  coffee,  consisting  of  about  100  c.c. 
and  made  with  15  grams  of  coffee,  contains,  ac- 
cording to  Gautier,  0.26  centigram  of  caffein. 
It  is  important  to  know  this  proportion. 

So  far  as  nutriment  is  concerned,  such  a 
draught  represents  only  15  calories  which  may 
be  raised  to  about  55  calories  by  adding  two 
lumps  of  sugar  (10  grams).  Of  course,  coffee 
with  milk  is  another  proposition.  The  nutritive 
power  is  increased  here  in  proportion  to  the 
amount  of  milk  added.  While  the  milk  tem- 
pers the  stimulating  properties  of  the  coffee,  the 
latter  adds  to  the  digestibility  of  the  milk. 


NERVE   FOODS  297 

It  is  worth  while  to  understand  the  reactions 
of  coffee  on  the  system  for  the  purpose  of  know- 
ing how  to  use  this  article,  because  coffee  is  a 
nerve  food,  and  possesses  properties  almost  iden- 
tical with  those  found  in  tea,  cocoa,  etc. 

The  action  on  the  stomach  is  very  slight  and 
favors  digestion.  Cold  coffee,  with  plenty  of 
water,  is  a  wholesome  beverage  and  does  not 
fatigue  the  stomach.  In  many  cases  of  dyspep- 
sia even  fairly  strong  coffee  is  by  no  means  dele- 
terious. Its  action  on  the  general  system  of 
circulation  is,  perhaps,  the  most  prominent,  cer- 
tainly above  all  vascular  and  nervous.  Coffee 
heightens  the  tension,  reinforces  and  modifies 
the  heart-beats,  raises  the  central  temperature, 
and  produces  a  feeling  of  warmth  and  comfort. 
It  impresses  the  nervous  system,  both  the  cere- 
bral and  the  muscular;  it  stimulates  the  power 
of  activity  and  relieves  the  feeling  of  fatigue, 
compensating  the  loss  of  energy  by  increased 
circular  activity.  The  writer  can  work  with  a 
clearer  mind  even  into  the  small  hours  of  the 
morning  after  sipping  his  cup  of  coffee;  the  la- 
borer, the  traveler,  the  merchant,  all  alike 
will  feel  renewed  vigor  and  forget  all  about 
fatigue  and  lassitude. 


298  WHAT   SHALL   I    EAT? 

The  action  of  coffee  may  thus  be  defined:  it 
augments  the  power  to  work,  but  in  no  wise 
modifies  the  consumption  of  calories  or  the  or- 
ganic wear  and  tear  in  a  given  task;  it  does  not 
add  to  the  productive  power  of  the  organism, 
nor  in  the  least  changes  the  relation  existing 
between  the  calories  utilized  in  the  work  accom- 
plished and  the  calories  lost  by  radiation.  Cof- 
fee is  by  no  means  a  food  of  economy.  If  some 
authorities  admit  that  it  diminishes,  in  a  slight 
measure,  the  consumption  of  albumin,  a  large 
majority  flatly  deny  it. 

In  this  respect  coffee,  being  neither  a  nutri- 
tive element  nor  a  food  of  economy,  is  inferior 
to  alcohol  (taken  in  small  doses),  which  possesses 
both  qualities. 

Resume. — If  coffee  increases  the  power  of  pro- 
duction, it  does  so  because  it  allows  of  a  tempo- 
rary abuse  of  the  physical  forces,  but  at  the  cost 
of  a  resulting  bodily  fatigue  and  increased  or- 
ganic expense,  which  must  be  compensated  by  a 
corresponding  amount  of  rest  and  sleep. 

Coffee  is  a  diuretic  and  acts  in  a  similar  fash- 
ion to  soup.  As  it  produces  uric  acid,  it  is  a 
strain  on  the  renal  capsules. 

In  its  action  on  the  organism,  coffee   obeys 


NERVE   FOODS  299 

the  general  law  which  governs  all  stimulants. 
Taken  in  small  doses  it  assists  the  system  in  its 
functions,  but  in  large  doses  it  becomes  toxic 
and  provokes  morbid  symptoms.  The  symp- 
toms of  caffeinism  are,  briefly,  the  following:  in 
the  vascular  system  palpitation,  sudden  flushing 
of  the  face,  anxiety,  oppression  in  the  region  of 
the  heart,  general  depression  in  the  nervous  sys- 
tem, insomnia,  muscular  weakness  with  trem- 
bling, and  a  general  state  of  neurasthenia  with 
inability  to  work. 

Small  doses  of  coffee  will  assist  the  workman 
engaged  in  manual  labor,  in  fact,  anybody  who 
has  to  undergo  fatiguing  work  or  exercise.  Al- 
cohol has  the  advantage  of  being  a  food,  in  fact, 
a  food  of  economy;  but  has  the  drawback  of  be- 
ing more  intoxicating.  As  an  habitual  tonic 
coffee  falls  behind  beer,  wine,  and  chocolate, 
which  are  nutrients  and  aliments  of  economy. 
It  is  ever  risky  to  expect  from  coffee,  for  any 
length  of  time,  the  stimulation  necessary  for  the 
performance  of  a  given  task  which  is  beyond  its 
powers.  Unfortunately,  a  mistaken  belief  leads 
only  too  often  to  the  abuse  of  this  beverage,  of 
which  principally  brain-workers  render  them- 
selves guilty.  But  it  is  an  error  committed 


300  WHAT  SHALL   I    EAT? 

by  the  working  man  as  well  as  by  the  female 
worker. 

In  pathology  coffee  finds  but  few  applications; 
chiefly  as  an  antidote  for  morphin  and  opium, 
or  in  cases  of  acute  alcoholism.  It  also  renders 
good  services  in  the  struggle  against  chronic 
alcoholism,  as  it  corrects  the  asthenia  of  absti- 
nence. In  surgery  it  is  employed  sometimes 
in  spinal  anesthesia  with  cocain  or  stovain,  in 
order  to  prevent  cardiovascular  symptoms.  In 
medicine,  caffein  in  its  pure  state  is  preferred, 
as  a  rule. 

Coffee  is  noxious  in  cardiac  disease,  in  angina, 
hypertension,  scleroma,  in  all  diseases  of  nervous 
origin  or  those  involving  the  heart;  and,  above 
all,  to  neurasthenics — those  excitable  creatures 
who  forever  fall  back  upon  the  abuse  of  this 
highly  prized  "Pick  me  up. "  Dyspeptics,  and  all 
those  subject  to  congestion  of  the  visual  organs 
or  to  varicosity  of  the  face,  acne  rosacea,  or 
psoriasis,  are  advised  to  use  coffee  in  moderation. 
Its  close  relationship  to  uric  acid  precludes  its 
use  in  all  cases  of  uricemia,  gout,  liver  complaints, 
and  arthritis. 

Kneip's  Malt  Coffee,  Postum  Coffee,  and  sim- 
ilar preparations  may  act  as  substitutes  for  cof- 


NERVE    FOODS  301 

fee  with  people  who  can  accustom  themselves  to 
their  rather  disagreeable  taste,  which,  however, 
may  be  somewhat  corrected  by  the  addition  of  a 
third  or  a  fourth  of  real  coffee. 

TEA 

The  use  of  tea  is  on  the  steady  increase 
throughout  the  world,  we  think,  for  the  general 
welfare  of  the  people;  for  it  is  a  most  wholesome 
and  hygienic  beverage. 

The  dried  and  more  or  less  toasted  leaves  con- 
tain nitrogenous  extracts,  cellulose,  gum,  dex- 
trin, a  fairly  large  proportion  of  oxalates,  ash  in 
which  phosphate  of  potassium  predominates, 
and,  above  all,  its  active  principle,  "thein"  [tri- 
methyl  xanthin],  similar  to  caffein  but  contain- 
ing a  larger  percentage  of  tannin.  Ceylon  tea 
is  somewhat  stronger  than  China  tea;  it  has 
a  thicker  and  browner  juice.  The  black  teas 
which  undergo  a  slight  fermentation  before  be- 
ing dried,  contain  a  smaller  amount  of  thein 
and  tannin  than  the  green  varieties. 

Although  the  composition  is  analogous,  the 
dose  of  the  active  principle  differs  greatly.  A 
cup  of  tea  of  120  c.c.  can  be  made  with  about  1 
gram  (a  pinch)  of  tea,  and  contains  0.4  gram 


302  WHAT   SHALL   I    EAT? 

of  soluble  substances,  and  only  0.025  gram  of 
thein,  or  ten  times  less  than  a  similar  cup  of 
coffee.  Its  nutritive  power  is  nil,  if  we  except 
the  sugar  and  milk  which  are  generally  added. 

The  action  of  tea  on  the  organism  is  almost 
the  same  as  that  of  coffee,  perhaps  a  little 
lighter. 

Tea  assists  digestion;  with  rum  it  is  used  with 
effect  in  heart  disease. 

The  large  percentage  of  tannin  makes  it 
slightly  binding. 

The  action  on  the  kidneys  and  on  the  neu- 
rovascular  system  differs  somewhat.  Excessive 
tea-drinking  is  apt  to  provoke  palpitation,  ver- 
tigo, neuralgia,  trembling,  irritability,  and 
emotional  nervousness;  yea,  even  symptoms 
bordering  on  epileptic  conditions  which  only 
cease  with  the  absolute  suppression  of  this 
alkaloid. 

Weak  concoctions  of  tea  make,  nevertheless, 
a  harmless,  indeed,  a  useful  beverage,  especially 
in  hot  climates,  as  the  water  used  for  the  pur- 
pose must  of  necessity  be  boiled,  thus  destroy- 
ing impurities  or  any  possible  bacilli  that  may 
be  contained  in  it. 

Dyspeptics   who    prefer   tepid    or    lukewarm 


NERVE   FOODS  303 

drinks  derive  much  benefit  from  a  cup  of  weak 
tea  sipped  warm  during  the  repast,  or  cold  after 
eating;  but  we  must  advise  moderation,  and  un- 
der circumstances  recommend,  rather,  infusions 
made  from  camomile  or  the  blossoms  of  the  lin- 
den-tree. 

Five  o'clock  tea,  or  afternoon  tea,  so  much 
in  vogue  in  certain  countries,  is  by  no  means 
wrong  in  principle.  For  people  in  good  health 
it  constitutes  a  useful  repast,  as  it  offers  a  wel- 
come stimulant  in  the  fatigues  of  the  daily  rou- 
tine. If  a  small  pat  of  butter  or  the  yolk  of  an 
egg  be  added,  it  even  becomes  a  nutriment. 
But  one  or  two  small  cups  must  be  the  limit. 
The  habit  of  gorging  one's  self  with  a  mass  of 
rich  cake  or  pastry — in  itself  heavy  and  indiges- 
tible— washed  down  with  three  or  four  or  more 
cups  of  tea,  is  bound  to  entail  serious  conse- 
quences and  endless  trouble. 

So  far  as  contraindications  are  concerned  we 
can  only  repeat  what  we  have  already  said  un- 
der the  head  of  coffee,  laying  particular  stress 
on  cases  of  oxaluria. 


WHAT  SHALL   I    EAT? 


COCOA1 

Chocolate  and  cocoa  deserve  special  mention, 
as  they  are  the  only  nerve  foods  which  possess  a 
real  nutritive  value.  The  cacao  bean  contains 
notable  proportions  of  albumin,  carbohydrates, 
and  fats.  In  the  manufacture  of  the  powdered 
article  a  large  amount  of  the  fat  (butter  of  ca- 
cao) is  removed,  until  the  following  proportions 
are  obtained: 

Albumin.       Fats.  Carbohydrates.    Ash.  Calories. 

Powdered  cocoa..    17         25          13         3.00         350 
Chocolate 57         22         62         1.70         487 

The  carbohydrates  consist  principally  of  cane- 
sugar.  The  oxalates  are  very  abundant,  4 
grams  per  50  kilograms.  The  ash  consists  of 
phosphate  and  sulphate  of  potassium  and  of 
magnesium. 

The  active  principle,  theobromin  (dimethyl 
xanthin),  which  reacts  very  much  like  caffein,  is 
less  prominent  in  cocoa  than  in  chocolate. 

As  for  the  rest,  chocolate  does  not  differ  from 
cocoa,  except  that  the  percentage  of  sugar  is 

1  We  have  adopted  here  the  spelling  in  general  use,  "cocoa," 
well  knowing  that  it  would  have  been  proper  to  follow  the 
scientific  spelling  "cacao." — (Translator.) 


NERVE   FOODS  305 

higher  (about  50  per  cent).  In  chocolates  of  in- 
ferior quality,  sugar  is  frequently  supplanted 
by  fecula. 

A  cup  of  sweetened  cocoa  made  with  10  grams 
of  the  powder  represents  about  74  calories,  and 
contains  in  the  neighborhood  of  0.13  centigram 
of  theobromin  and  0.045  of  oxalates.  A  cup  of 
chocolate  made  with  15  grams  of  the  powder 
represents  the  same  number  of  calories;  it  con- 
tains 0.19  centigram  of  theobromin,  but  only 
0.012  of  oxalates. 

The  physiological  action  of  cocoa  approaches 
that  of  coffee  and  tea  very  closely,  but  is  mod- 
erated by  the  presence  of  fats  and  sugar,  which 
make  theobromin  less  stimulating  than  caffein. 
That  is  the  reason  why  cocoa  is  borne  better  by 
dyspeptics  than  chocolate;  but  it  ferments  eas- 
ily, and  is  binding,  which  is  a  drawback. 

Vascular,  cerebral,  and  muscular  stimulation 
and  diuretic  action  are  less  pronounced,  but  the 
general  tonic  action  is  stronger  and  more  rapid. 
A  cup  of  cocoa  or  chocolate  promptly  produces 
a  feeling  of  comfort  which,  as  Gautier  so  tritely 
says,  can  only  be  explained  as  "a  nervous  effect 
provoked  by  the  flavor  of  cocoa,  sustained  by 
the  tonic  influence  of  theobromin,  and  completed 


306  WHAT  SHALL   I    EAT? 

by  the  nutritive  element  of  the  food  in  direct 
ratio  to  the  amount  absorbed. ' ' 

People  who  are  engaged  in  outdoor  exercise  or 
sport  should  bear  that  in  mind;  likewise  those 
who  are  depressed  in  spirit,  convalescents,  or  hy- 
popeptics.  For  forced  alimentation  a  cup  of  choc- 
olate with  150  c.c.  of  milk  and  the  yolk  of  two 
eggs  will  do  much.  It  represents  at  least  300 
calories. 

But  chocolate  should  never  be  made  the  base 
of  a  diet.  Excessive  use  is  bad  for  the  stomach 
and  the  bowels,  in  fact,  for  the  whole  system. 
Martinet  quotes  the  case  of  a  man  sixty  years  of 
age  who  brought  on  a  serious  attack  of  gener- 
alized rheumatism  by  having  lived  on  chocolate 
exclusively  for  several  years. 

Children  are  more  sensitive  in  this  regard 
than  adults,  and  a  special  danger  lurks  in  the 
circumstance  that  many  farinaceous  baby  foods 
are  flavored  with  cocoa. 

Variot  claims  that  children  who  are  surfeited 
with  cocoa  are  constipated,  puffed  up,  flabby, 
frail,  nervous,  and  peevish. 

Cocoa  is  a  food  simply  for  sustenance,  but  not 
for  development.  —  (Guinon.) 

We  warn  here  also  against  the  too  frequent 


NERVE   FOODS  307 

use  of  chocolate  candies,  which  overload  and  ob- 
struct the  stomach  and  the  intestinal  canal,  spoil 
the  appetite,  and  cause  carious  teeth. 

In  gout,,  gravelt  uricemia,  rheumatism,  cardiac 
and  Bright' 's  disease,  arthritis,  arthritic  constipa- 
tion, they  are  dangerous  titbits.  In  liver  com- 
plaints, diabetes,  and  oxaluria,  chocolate  must  be 
rigidly  avoided.  Persons  suffering  from  diabetes 
or  heart  disease  may  partake  of  cocoa  in  small 
doses,  but  never  when  sweetened  with  sugar. 
So  far  as  the  other  categories  of  disease  enu- 
merated above  are  concerned,  cocoa  ranks  even 
with  chocolate.1 

1  Not  so  much  on  account  of  the  chocolate,  but  of  the  impu- 
rities, such  as  paraffin,  which  they  contain  (so-called  milk  choco- 
late), and  especially  on  account  of  saccharine  and  sugar. — 
(Translator.) 


BEVERAGES 

NATURAL    WATER 

WATER  is  the  most  necessary  substance,  with- 
out which  man  cannot  endure  for  any  length  of 
time.  Even  when  fasting  for  a  period  of  days, 
we  cannot  exist  without  a  given  quantity  of 
water.  Of  course,  this  is  quite  natural,  for 
water  is  the  principal  constituent  of  our  cellu- 
lar system;  and,  being  constantly  eliminated 
through  the  kidneys,  the  intestines,  the  lungs, 
and  the  skin,  it  must  be  incessantly  replenished 
by  daily  rations. 

The  normal  human  being  excretes  every 
twenty-four  hours 

1,500  c.c.  of  water  through  the  urine, 
60  c.  c.  of  water  through  the  feces, 
900  c.c.  of  water  through  the  lungs  and  skin. 

Total 2,460  c.c. 

Of  this  quantity  about  1,400  c.c.  are  carried 
into  the  system  by  the  food  we  eat,  of  which 
nearly  400  c.c.  are  derived  from  the  oxidation 

308 


BEVERAGBS  309 

of  the  hydrogen  contained  in  the  foodstuffs  in- 
gested. So  that  we  have  to  supply  just  a  little 
more  than  a  liter  of  fluid  in  order  to  satisfy  the 
demand. 

Moreover,  physical  exertion  strongly  changes 
and  affects  the  elimination  of  water,  i.  e. ,  on  an 
average  of 

1,000  c.c.  through  the  urine, 
60  c.c.  through  the  feces, 
1,900  c.c.  through  the  lungs  and  the  skin. 


Total....  2,960  c.c. 

The  percentage  of  water  contained  in  the  food 
is  subject  to  very  little  change,  while  the  ratio 
required  for  work,  oscillating  between  a  liter 
and  a  half  and  two  liters  a  day,  must  be  main- 
tained for  the  proper  functioning  of  the  tissues. 
It  is  true  that  the  renal  secretions  act  as  a  regu- 
lating force  in  this  process  of  supplying  mois- 
ture, being  scant  when  the  supply  is  small,  but 
profuse  when  the  proper  measure  is  exceeded; 
also  that  cutaneous  and  pulmonary  excretions 
play  only  a  subordinate  role  in  this  game  of 
compensation. 

But  it  becomes  a  matter  of  urgent  necessity 
that  the  natural  laws  should  not  be  transgressed, 


310  WHAT  SHALL   I    EAT? 

one  way  or  the  other.  Drinking  too  little  water 
is  just  as  injurious  as  drinking  too  much.  The 
former  dries  up  the  tissues  and  allows  of  an 
undue  accumulation  of  toxic  deposits,  especially 
of  uric  acid,  which  may  cause  a  lot  of  trouble. 
On  the  other  hand,  the  latter  soon  degenerates 
into  an  evil  habit,  with  all  its  baneful  effects  on 
the  heart  and  circulation,  by  supplying  a  pleth- 
ora of  watery  elements;  and  on  nutrition,  by  re- 
tarding its  progress  and  leading  to^obesity. 

A  thorough  understanding  of  these  laws  will 
materially  aid  in  finding  the  just  proportion  for 
the  healthy  individual,  while  it  will  also  indi- 
cate the  proper  adjustment  of  the  quantity  of 
liquid  required  for  different  regimens. 

There  is,  first  of  all,  the  dry  diet — prized  so 
highly  in  the  major  dilatations  of  the  stomach— 
the  aim  of  which  is  to  avoid  alimentary  surfeit 
and  the  dilution  of  gastric  juices,  which  precipi- 
tate putrefaction.  The  idea  itself  is  all  right 
enough,  but  it  must  not  be  pushed  to  the  ex- 
treme; for,  after  all,  in  cases  of  dilatation  or  gas- 
tric fermentation,  or  even  hypopeptic  affections, 
it  quite  suffices  to  restrict  the  patient  to  a  diet 
of  thick  soups  and  the  smallest  allowance  of  bev- 
erage during  the  meal,  to  effect  a  marked  im- 


BEVERAGES  311 

provement.  One  small  glass  of  water  should  be 
the  limit,  but  that  is  always  required  for  prop- 
erly stimulating  the  appetite  and  forming 
the  chyme  needed  for  the  process  of  digestion. 
Moreover,  it  is  wise  to  drink  a  glass  of  water  be- 
tween meals  when  the  stomach  is  comparatively 
empty,  to  support  its  action. 

Restriction  in  the  use  of  water  forms  a  part 
of  the  treatment  in  obesity;  it  is  the  fundamen- 
tal principle  in  Oertel's  cure.  Stout  people 
should  drink  but  little  water,  and  never  during 
meals.  Less  than  a  liter  per  day  is  the  norm. 
But  this  again  depends  upon  the  fact  whether 
the  formation  of  adipose  tissue  is  occasioned  by 
arthritic  or  toxic  matter.  Oertel's  cure  does 
not  agree  with  every  individual  case,  and  re- 
quires careful  supervision  and  never-ceasing 
vigilance.  A  judicious  restriction  in  the  use  of 
chlorinated  substances  will  often  prove  to  be  of 
better  advantage.  —  (M .  Labbe. ) 

Patients  suffering  from  cardiac  troubles,  or 
from  Bright' s  disease,  are  likely  to  derive  benefit 
from  this  selfsame  treatment.  If  there  is  a  ten- 
dency to  drink  often  and  much,  it  is  prudent  to 
restrict  the  daily  ration  to  1,500  c.c.  without 
fear  of  restraining  the  proper  flushing  of  the 


312  WHAT  SHALL   I    EAT? 

kidneys.  On  the  contrary,  much  comfort  will 
be  experienced  in  the  heart's  action  and  that 
of  the  renal  capsules.  —  ( Widal. )  But,  be  it 
remembered,  in  order  to  obtain  satisfactory 
results,  protracted  treatment  is  a  conditio  sine 
qua  non.  1 

However,  there  are  many  morbid  conditions 
which  demand  an  excess  of  the  normal  quotum; 
for  instance,  gout  and  uricemia,  which  require 
large  quantities  of  water  for  ridding  the  system 
of  a  surcharge  of  uric  acid.  But  even  here 
moderation  is  a  hard  and  fast  rule.  Diuresis  is 
always  the  criterion.  One  liter  and  a  half  to 
two  liters  is  the  average.  Anything  beyond 
that  is  a  strain  on  the  heart. 

The  term  "natural  water"  applies  to  the  nat- 
ural product  containing  no  mineral  or  chemical 
substances  foreign  to  its  essential  organic  or  in- 
organic composition. 

Genuine  potable  "table"  water  must  be 
"fresh,  limpid,  free  of  odor,  slightly  alkaline, 
agreeable  to  the  taste,  easy  on  the  stomach, 


1  It  is  well  to  bear  in  mind  that  in  pathological  conditions 
the  system  absorbs  only  very  minute  quantities  of  water  from 
the  solid  foods,  so  that  1,500  c.c.  represents  in  reality  only  an 
inferior  percentage  of  the  daily  allowance. 


BEVERAGES  313 

aerated,  free  from  putrefaction,  and  fit  for  com- 
mon domestic  consumption."  —(Gautier.) 

We  may,  with  advantage,  dwell  upon  a  few  of 
these  qualities.  Aeration  is  conducive  to  diges- 
tibility; badly  aerated  waters  press  upon  the 
stomach,  not  so  much  on  account  of  the  absence 
of  oxygen,  but  because  they  are  too  much  im- 
pregnated with  organic  matter,  which  easily 
putrefies  and  becomes  injurious  by  absorbing 
oxygen  from,  instead  of  conveying  it  to  the  sys- 
tem. Chalk  is  another  important  factor.  Good, 
healthy  drinking-water  should  contain  about 
0.500  to  9.300  grams  of  mineral  matter,  and 
0.300  to  9.100  grams  of  carbonate  of  lime  per 
liter.  This  hydric  chalk  forms  a  mineral  co- 
efficient in  our  daily  ration  not  to  be  neglected; 
and,  if  wanting,  will  seriously  affect  the  consti- 
tution, especially  in  the  young.  If  present  to 
excess  it  will  do  harm,  because  it  makes  the 
water  hard  and  unfit  for  cooking  vegetables. 

The  most  important  quality  of  good  drinking- 
water  is  sterility;  in  other  words,  water  must  be 
free  from  pathogenic  microbes,  above  all — in  the 
heated  season.  In  the  summer  months  infec- 
tion is  chiefly  due  to  Eberth's  bacillus,  and  spe- 
cial precautions  are  required  to  secure  sterility. 


WHAT   SHALL   I    EAT? 

Boiling  has  its  advantages,  but,  unfortunately, 
it  precipitates  the  essential  salts.  The  filter  is, 
perhaps,  preferable,  but  it  requires  everlasting 
cleaning.  Filters  should  be  boiled  at  least  once 
a  week. 

Natural  mineral  waters,  if  selected  with  cau- 
tion, are  all  right  enough  for  a  certain  period; 
but,  if  excessively  used,  they  have  their  draw- 
backs also.  They  are  really  intended  for  mor- 
bid conditions  of  the  body. 

On  the  whole,  the  water  provided  by  the  mu- 
nicipal authorities  of  large  cities  is  healthy  and 
fit  to  drink,  especially  if  the  supply  is  carefully 
guarded  against  noxious  infiltrations  from  sur- 
rounding sources. 

Rain  water,  gathered  in  cisterns,  lacks  the 
necessary  percentage  of  salts  and  mineral  mat- 
ters, and  is  apt  to  contain  microbic  substances. 
River  water  is,  as  a  rule,  contaminated,  and 
therefore  risky. 

Water  should  be  consumed  during  meals.  To 
drink  water  only  before  or  after  eating  we  con- 
sider a  bad  habit,  especially  in  persons  of  seden- 
tary habits.  But  we  recommend  taking  a  glass 
or  two  of  water  before  bedtime,  to  persons  who 
are  troubled  with  indigestion  or  plethora. 


BEVERAGES  315 

The  man  who  toils  requires  more  water  be- 
tween meals;  but,  if  he  can  accustom  himself  to 
the  habit  of  drinking  only  with  his  repast,  he 
will  be  benefited  by  it. 

To  sum  up,  our  drinking-water  should  be 
always  fresh  and  cool,  although  tepid  water  will 
agree  better  with  dyspeptics.  Ice-water,  or  very 
cold  spring  water,  is  ever  harmful. 


316  WHAT  SHALL   I    EAT  ? 


ALCOHOLIC    BEVERAGES 

Water,  pure  and  simple,  barring  exceptional 
cases,  has  never  constituted  the  only  and  exclu- 
sive beverage  among  the  nations  inhabiting  this 
mundane  sphere.  In  all  ages  throughout  the 
world  liquid  refreshments  containing  alcohol 
have  enjoyed  a  special  privilege  and  have  been 
held  in  high  repute.  The  methods  of  preparing 
them,  the  taste,  the  strength  are  ever  changing 
with  the  habits,  the  customs,  and  opinions  of 
individual  peoples;  but  they  all  present,  in  the 
principle,  the  same  beneficial  and  deleterious 
characteristic  qualities. 

Here  we  are  at  once  face  to  face  with  one  of 
the  burning  questions  of  the  age — the  social 
problem  of  the  period,  viz.,  alcoholism.  It  is 
quite  impossible  to  deal,  in  a  short  chapter,  with 
this  important  subject,  on  behalf  of  which  oceans 
of  ink  have  already  flowed  from  a  thousand  pens 
of  able  writers — a  question  which  enlists  the  in- 
terest of  the  pathologist,  hygienist,  sociologist, 
and  moralist,  as  well  as  that  of  the  political  econ- 
omist. The  lines  which  we  intend  to  follow  are 
of  a  threefold  nature.  1.  We  shall  rehearse  the 


BEVERAGES  317 

principles  which  seem  to  be  more  or  less  es- 
tablished, at  the  present  moment,  as  to  profit 
and  loss  in  the  use  of  alcohol.  2.  We  shall  con- 
sider the  percentage  of  alcohol  contained  in  va- 
rious beverages.  3.  We  shall  enumerate  and 
give  the  advantages  and  disadvantages  of  such 
substances  as  may  act  as  equivalents  of,  or  sub- 
stitutes for,  alcohol. 

ALCOHOL 

1.  Is  alcohol  a  food;  or,  in  other  words,  is  our 
organism  capable  of  burning  up  alcohol  intro- 
duced into  our  system  to  advantage,  and  of  util- 
izing its  heat  for  the  purpose  of  meeting  our 
calorific  needs?  This  question  has  been  fully 
discussed  from  every  possible  point  of  view,  and 
has  been  the  subject  of  innumerable  experi- 
ments, seemingly  in  favor  of  the  affirmative. 
The  claims  advanced  by  Atwater  appear  to  be 
most  conclusive.  He  put  a  man  into  a  calori- 
metric  chamber  for  a  period  of  three  days,  ascer- 
taining all  the  time  the  number  of  calories 
obtained  by  a  given  non-alcoholic  regimen. 
During  the  next  three  days  he  substituted  an 
isodynamic  quantity  of  alcohol  for  an  equivalent 
amount  of  carbohydrates,  resuming  the  original 


318  WHAT  SHALL   I    EAT  ? 

non-alcoholic  regimen  for  the  subsequent  three 
days.  The  resultant  in  calories,  in  both  in- 
stances, was  the  same  within  one  thousandth 
part  of  1  per  cent.  The  conclusion,  therefore, 
is  that  alcohol  is  utilized  by  the  organism,  and, 
as  a  nutrient  can  replace  an  equivalent  amount 
of  sugar  or  starch.  But  this  holds  good  only 
when  alcohol  is  absorbed  in  small  quantities. 
If  consumed  in  large  quantities  it  is,  in  part, 
eliminated  through  the  lungs,  through  the  kid- 
neys, and  by  perspiration,  without  being  utilized 
by  the  economy.  Thus  we  are  aided  in  making 
an  exact  calculation  as  to  the  quantity  and  pro- 
portion of  the  alimentary  value  contained  in 
alcohol. 

The  isodynamic  equivalent  of  alcohol  is  7  per 
cent;  that  is  to  say,  one  gram  of  alcohol  will 
give  7  calories;  or,  to  be  quite  accurate,  7.184. 
It  is  evident  that  this  percentage  exceeds  that 
of  carbohydrates  and  of  albumin,  and  almost 
equals  that  of  the  fats. 

2.  Reactions. — The  action  of  alcohol  on  the 
stomach  is  well  defined,  and  subject  to  two  fac- 
tors, i.  e. ,  quantity  and  concentration.  In  small 
doses,  and  when  of  low  proof  (50  per  cent),  al- 
cohol facilitates  the  task  of  the  stomach,  espe- 


BEVERAGES  319 

cially  its  secretory  functions — a  fact  which  is  well 
known  and  often  brought  into  practical  use  with 
advantage.  Strong  and  oft-repeated  doses  of 
high-proof  spirits  irritate  the  gastric  mucous 
membranes,  give  rise  to  functional  troubles  and 
to  anatomical  lesions  on  parallel  lines,  to  hyper- 
chlorhydria,  to  mucous  hypersecretion,  to  apep- 
sia  with  corresponding  glandular  proliferation, 
accumulation  of  mucous  elements  and  mucous 
atrophy.  Often  these  lesions  do  not  last  a  long 
time,  but  break  out  as  ulcers,  nearly  always 
followed  by  hematomesis. 

There  is  scarcely  any  direct  action  on  the  in- 
testines, as  alcohol  is  nearly  fully  absorbed  by 
the  stomach ;  but  the  secondary  reflex  action  dis- 
turbs the  gastric  functions  throughout  the  whole 
length  of  the  tube.  The  first  point  of  attack  is 
the  liver.  Small  doses  congest  the  parenchyma, 
and  excite  the  cellular  stricture;  strong  and  fre- 
quent doses  provoke  a  reaction  in  the  connective 
tissues.  Clinical  experience  has  shown  that  al- 
cohol, in  its  very  diluted  form — for  instance, 
wine — constitutes  one  of  the  principal  factors  in 
cirrhosis;  but,  in  massive  doses,  it  clogs  the 
hepatic  cellular  structure,  and  may  bring  on 
grave  attacks  of  jaundice. 


320  WHAT  SHALL   I    EAT? 

The  circulatory  system  is  likewise  affected, 
for  it  accelerates  the  heart's  action,  hastens 
the  circulation,  causes  congestion  of  the  face 
by  vasodilatation,  and  produces  an  appreciable 
sensation  of  heat.  Prolonged  abuse  frequently 
leads  to  cardiovascular  sclerosis. 

Its  tonic  and  exciting  action  extends,  in  equal 
measure,  to  the  nerve-centers;  hence  it  may  be 
considered  a  nerve  food,  like  coffee  and  tea.  It 
is  universally  acknowledged  that  alcohol  pro- 
duces a  feeling  of  euphoria,  diminishes  fatigue, 
and  augments,  for  the  moment  at  least,  mus- 
cular power  and  cerebral  activity.  Poets  with- 
out number,  and  writers  in  every  branch  of 
literature,  often  enough  seek  inspiration  in  the 
cup  that  cheers. 

Alcohol  certainly  influences  the  general  pro- 
cess of  digestion,  and  here  again  the  question  of 
quantity  is  of  the  utmost  importance.  It  un- 
doubtedly accounts  for  the  many  contradictory 
results  obtained  in  experimental  research.  A 
small  dose  of  alcohol,  i.e.,  less  than  one  gram 
per  kilogram,  diminishes  the  percentage  of  ni- 
trogen in  the  urine,  and  restrains,  in  clearly  de- 
fined proportion,  the  disassimilation  of  fats  and 
albumin.  In  this  regard  it  is  inferior  to  fat,  and 


BEVERAGES  321 

still  more  so  to  carbohydrates;  on  the  contrary, 
in  strong  doses  it  augments  this  disassimilation 
of  nitrogen  and  the  excretion  of  urea.  If,  in  the 
former  case,  its  action  is  simply  that  of  a  tonic, 
in  the  latter  it  comports  itself  as  a  violent  stim- 
ulant. 

Normally,  alcohol  acts  through  the  kidneys. 
It  is  burned  up  there  and  eliminated  in  the 
form  of  water  and  carbonic  acid.  By  itsjsclero- 
sing  action  on  the  vessels  it  may  seriously  handi- 
cap the  renal  functions. 

Alcohol  is  endowed  with  a  twofold  character: 
it  is  a  food  as  well  as  a  nervine.  As  a  food  it 
possesses  a  nutritive  value  which  is  far  from  be- 
ing negligible;  as  a  nervine  it  sways,  by  way  of 
the  nervous  system,  a  notable  stimulating  power 
over  all  the  functions  of  the  body.  But,  as  is 
the  case  with  all  substances  belonging  to  this 
category,  it  cannot  be  ingested  in  quantities 
even  in  the  slightest  degree  excessive,  without 
detriment  to  the  organism.  It  is  really  a  dan- 
gerous food,  as  it  is  strongly  intoxicating,  and 
its  use  has  to  be  forever  most  carefully  watched 
and  controlled.  Just  so  soon  as  the  normal  dose 
is  exceeded,  alcohol  no  longer  nourishes;  it  in- 
toxicates. It  gives  off  its  heat  rapidly,  so  to 


WHAT  SHALL   I    EAT? 

speak  in  a  brutal  manner,  and  the  best  part  of 
it  is  lost  without  profit  to  the  system.  Instead 
of  deriving  a  benign  stimulation  from  its  inges- 
tion,  the  organs  find  themselves  quickly  in  the 
turmoil  of  excessive  excitation,  which  is  fatally 
followed  by  a  pronounced  depression  demanding 
fresh  libations  of  the  stimulating  fluid  and  in 
ever-increasing  quantities.  This  succession  of 
alternatives  is  very  baneful,  and  lays  the  foun- 
dation for  gastritis,  cirrhosis  of  the  liver,  cardio- 
vascular sclerosis;  the  faculty  for  physical  work 
is  diminished  (Chauveau),  cerebral  productivity 
becomes  more  and  more  impaired,  nutrition  is 
inhibited,  followed  by  pathological  conditions 
such  as  arthritis,  and  even  tuberculosis. 

These  general  remarks  will  assist  us  greatly 
in  forming  a  correct  judgment  of  the  respective 
value  of  the  various  alcoholic  beverages  under 
consideration.  The  first  rule  to  be  observed  is, 
to  avoid  altogether  all  that  have  a  strong  con- 
centration; that  is,  a  high  percentage  of  alcohol. 
The  second  is,  beverages  in  which  alcohol  is 
strongly  diluted,  are  permissible. 

Nevertheless,  the  problem  is  not  without  vexa- 
tious complications  on  account  of  the  presence 
of  secondary  substances — alcohols  of  superior 


BEVERAGES  323 

grades,  essences,  and  different  compounds,  which 
add  their  useful  or  noxious  effects  to  the  basic 
action  of  alcohol. 

ABSINTH — APERIENTS — LIQUEURS 

All  these  products,  although  of  widely  differ- 
ing composition,  deserve  to  be  gathered  under 
the  common  title  of  reprobation.  The  parti- 
sans in  the  antialcoholic  war  are  all  in  accord 
in  demanding  their  absolute  and  unconditional 
suppression. 

Their  intoxicating  power  is  chiefly  due  to  the 
high  percentage  of  alcohol,  as  will  be  apparent 
from  the  following  table: 

f  Vermouth 

From  20  to  30  per  cent •{  „.,.        /TV       x 

[  Bitters  (Picon) 

f  Sweetened  liqueurs 

From  30  to  40  per  cent <  Kummel 

[_  Black  currant  catafia,  etc 
Anisette 


From  40  to  50  per  cent . 


Chartreuse 
Apple-Jack 


Cognac 

_  Kirsch 

f  Bitters 
From  50  to  60  per  cent <  Curac.no 

[Rum 
From  60  to  80  per  cent Absinth 

Their    deleterious   qualities    are   further    in 
creased  by  the  addition  of   superior  alcohols— 


324  WHAT   SHALL   I    EAT  ? 

much  more  intoxicating  than  ethyl  alcohol — and 
certain  essences  particularly  noxious  to  the  ner- 
vous system. 

Absinth  easily  tops  the  scale  of  toxicity.  It 
is  a  violent  poison  for  the  nervous  cells.  Ab- 
sinthism  has  in  its  wake,  neurosis,  epilepsy,  in- 
sanity; and,  for  the  offspring,  nervous  defects 
without  end  and  number. 

The  aperients  follow  in  second  line.  They 
contain  so-called  aperient  substances  macerated 
with  the  alcohol.  In  reality,  they  are  most 
harmful  to  the  functions  of  the  stomach;  in 
fact,  as  a  rule,  they  ruin  the  stomach  first,  be- 
fore they  strike  the  liver  and  the  arterial  system. 

Liqueurs  enjoy  a  slightly  better  reputation. 
Nevertheless,  they  contain  a  very  large  percent- 
age of  ethyl  alcohol,  with  the  admixture  of 
other  high  grade  alcohols  such  as  propylic,  bu- 
tylic,  amylic,  etc. ,  and  of  ether  in  varying  quan- 
tities, by  no  means  negligible.  And  yet  we 
speak  here  only  of  the  highest  grades  of  spirit- 
uous preparations.  If  the  unfortunate  working- 
man  only  knew  the  nature  of  these  admixtures 
that  are  put  into  what  is  given  him  to  drink,  he 
might  be  more  cautious  and  reserved  in  his  po- 
tations. 


BEVERAGES  325 

It  is  the  abusive  use  of  liquor  and  wine  that 
builds  up  the  long  list  of  cases  of  chronic  alco 
holism,  with  its  formidable  retinue  of  gastric, 
hepatic,  and  vascular  complications.  The  worst 
feature  of  this  sad  state  of  affairs  is  the  fact  that 
it  is  by  no  means  due  to  excessive  periodical 
drinking.  It  is  the  regular  daily  consumption 
of  even  moderate  doses  that  plays  the  havoc. 
The  man  who  drinks,  say  one  glass  (20  grams) 
of  cognac  or  whisky,  or  any  other  drink  after 
each  meal,  consumes  20  c.c.  of  alcohol  every 
twenty-four  hours,  or  an  equivalent  of  at  least 
one-third  of  the  maximum  dose  permissible. 
Add  to  this  the  usual  quota  of  malt  liquors  and 
wine  taken  during  the  meal,  and  it  will  be  at 
once  apparent  that  the  grand  total  of  alcoholic 
liquid  consumed  borders  on  or  exceeds  the  limit 
of  what  may  be  considered  innocuous. 

The  steady,  daily  consumption  of  alcohol  by 
persons  otherwise  in  good  health,  claims,  there- 
fore, serious  attention,  and  should  be  combated 
as  profitless  and  outright  injurious. 

It  is  different  when  we  have  to  deal  with 
pathological  conditions,  however,  in  which  alco- 
hol may  render  truly  beneficial  services.  Ther- 
mic and  neurovascular  stimulation  and  cardiac 


326  WHAT  SHALL   I    EAT? 

tonicity  engendered  by  its  application  prove 
extremely  useful  in  the  treatment  of  grave 
infections  with  nervous  asthenia,  slow  pulsation, 
syncope,  hypothermia,  and  general  collapse;  like- 
wise in  typhoid  pneumonia,  infectious  grippe, 
typhoid  adynamic 'fevers,  and,  generally  speaking, 
in  all  infectious  diseases  which  are  accompanied 
by  cardiovascular  asthenia.  Even  heroic  doses 
of,  say,  100  grams  of  rum  or  cognac  per  day, 
are  not  fraught  with  danger.  Alcohol  acts  in 
these  cases  like  a  medicament,  a  food,  since  100 
grams  mixed  with  sugar  will  give  as  much  as 
470  calories,  and  will  limit,  like  an  aliment  of 
economy,  disassimilation. 

Its  value  in  this  respect  is  of  the  same  import 
in  the  fever  patient  and  the  healthy  person 
alike.  —  (Ott.) 

Alcohol  has,  in  recent  years,  been  strongly  rec- 
ommended to  diabetics,  because  it  furthers  the 
tolerance  of  fats  by  the  stomach,  acts  not  only 
as  a  nutriment,  but  also  exerts  a  happy  influ- 
ence over  the  utilization  of  sugar,  and  mini- 
mizes the  chances  of  interference  by  acetonuria. 
But,  particular  care  must  be  taken  not  to  exceed 
the  proper  measure,  or  to  neglect  the  special 
contraindications  given  for  individual  cases. 


WINES 

Alcohol 
by  Weight.        Carbohydrates.  Ash.  Purin.  Chlorid.     Calories. l 

5.7  to  8.6     1.7  to  2.8     0.11  to  0.26      0        0      47  to  74 


IT  is  evident  that  wine  is  entirely  free  from 
fatty  and  nitrogenous  substances,  and  from  pu- 
rin  bodies. 

Ethyl  alcohol  is  the  principal  compound,  the 
percentage  of  which  varies  with  the  different 
growths.  We  affix  here  a  table,  giving  the 
names  of  the  best  known  brands  of  wine  and 
their  respective  percentage  of  alcoholic  content. 

From  9  to  10  Per  Cent. 

Bourgogne,  red  ordinary. 

white  ordinary. 
Bordeaux,  ordinary. 

red — special  growth. 

white — special  growth. 
Gers. 
Alsatian,  white. 

'These  figures  do  not  refer  to  the  heavy  "liqueur"  wines 
such  as  Madeira  and  Port,  etc.,  nor  to  Champagne, 

327 


328  WHAT   SHALL   I    EAT? 

From  11   to  12  Per  Cent. 

Bourgogne,  special  growth. 

Medoc. 

Narbonne. 

Algerian  wines. 

Rhine  wines. 

Tokay. 

From  13  to  15  Per  Cent. 

D'Asti. 

Spanish  wines. 
Champagne. 

From  15  to  17  Per  Cent. 

Port. 

Madeira. 

Marsala. 

It  is  important  to  be  familiar  with  these  fig- 
ures, for  often  it  may  be  opportune  to  remind  a 
patient  inclined  to  a  liberal  use  of  wine  that  a 
bottle  of  Bordeaux  represents  about  66  c.c.  of 
absolute  alcohol,  or  a  glass  of  Champagne  17  c.c., 
or  a  glass  of  Madeira  7  c.c.  A  calculation  on 
the  total  amount  of  alcohol  absorbed  during 
twenty-four  hours  will  sometimes  not  a  little 
surprise  the  patient. 

The  ethyl  alcohol  is  accompanied  by  su- 
perior alcohols,  such  as  propylic,  butilic,  and 


WINES  329 

amylic,  which  are  intoxicating  in  a  much  higher 
degree;  but,  luckily,  present  only  in  small  quan- 
tities, though  the  proportion  is  higher  in  those 
growths  the  aromatic  flavor  (bouquet)  of  which 
is  more  prominent. 

Among  the  carbohydrates  special  mention 
must  be  made  of  glycerin — it  varies  from  4  to 
13  grams  per  liter — mannite,  levulose,  and  glu- 
cose. The  two  last-named  substances  are  espe- 
cially abundant  in  certain  liqueur  wines  such 
as  Malaga,  which  may  contain  as  much  as  150 
grams  per  liter. 

Wine  contains  organic  acids,  principally  tar- 
taric  acid,  found  almost  entirely  in  the  potassium, 
and  is  particularly  abundant  in  the  Medocs  and 
the  wines  from  the  Bourgogne;  also  cenotannic 
acid,  up  to  2  grams  in  the  red  wines — the  white 
wines  show  only  traces  in  the  summer-time;  of 
mineral  acids,  sulphuric  and  phosphoric  acids 
are  present.  Among  the  basic  substances  po- 
tassium, lime,  magnesium,  and  iron  may  be 
mentioned;  they  vary  from  0.008  gram  to  0.05 
gram  per  liter. 

The  percentage  of  acidity  is  weakest  in  the 
Alsatian  and  Bordeaux  wines;  it  increases  in  the 
order  named  here  in  the  Rhine  wines  and  Alge- 


330  WHAT  SHALL   I    EAT? 

rian,  in  Madeira,  Marsala,  and  Champagne,  and 
in  the  red;  and  still  more  so  in  the  white  wines 
from  the  Bourgogne,  reaching  the  highest  vol- 
ume in  the  Muscat  d'Asti.  As  a  portion  of  this 
acidity  is  organic,  and  consumed  by  combustion, 
wine  is,  so  far  as  nutrition  is  concerned,  in  reality 
but  slightly  acid. 

There  is  no  need  for  discussing  here  the  reac- 
tion of  wine  on  our  organism,  as  it  coincides  with 
what  we  have  already  said  about  alcohol  in  a 
strongly  diluted  state.  We  will,  however,  make 
mention  of  the  evil  effects  of  tartaric  acid  which 
is  apt  to  fatigue  the  stomach,  and  those  of  tan- 
nin which  make  the  red  wines  rather  binding. 
The  white  wines  are  diuretic.  Very  young 
wines  often  enough  irritate  the  intestinal  canal 
and  produce  diarrhea. 

Adulterations.  — Not  so  very  long  ago  this  en- 
terprise had  assumed  formidable  dimensions  and 
contributed  not  a  little  to  that  vigorous  cam- 
paign against  the  use  of  wine  in  general,  which 
was  then  being  waged,  but  overproduction  of 
the  genuine  article  has  largely  contributed  to 
relegate  it  to  the  past.  The  most  inoffensive 
methods  are  watering,  sugaring,  and  the  blend- 
ing of  different  vintages.  The  addition  of 


WINES  331 

coloring  matter,  especially  of  fuchsin,  often  con- 
taining arsenic,  is  harmful.  While  the  admixture 
of  sulphate  of  potassium  for  the  purpose  of  pre- 
cipitating the  albuminoids  and  microbic  sub- 
stances, called  "platrage"  by  the  French,  is 
absolutely  injurious  to  the  stomach.  [The  so- 
called  artificial  wines  manufactured  from  sub- 
stances foreign  to  grape- juice  deserve  no  spe- 
cial mention  here,  as  they  contain  none  of  the 
qualities  attributable  to  the  genuine  article. — 
Translator.  ] 

Indications  and  Contraindications.  — We  do  not 
hesitate  to  range  wine  among  what  is  rightly 
called  * '  hygienic  beverages. ' '  We  have  already 
pointed  out  the  tonic  and  nutritive  effects  of  al- 
cohol when  consumed  in  small  doses;  and  with 
wine  it  is  comparatively  easy  to  restrict  the  use 
to  minor  quantities.  A  bottle  of  wine  of  600 
c.c.  contains  about  60  c.c.  of  absolute  alcohol, 
or  less  than  the  maximum  allowance  for  an 
adult  of  middle  weight.  If  this  quotum  is  not 
exceeded  in  twenty-four  hours,  the  wine  will  act 
as  a  rational  stimulus  to  the  different  organs  of 
the  body  and  further  their  functioning  powers 
in  a  useful  manner.  This  benign  influence  is 
strongly  felt  by  those  who  lead  a  strenuous  life, 


332  WHAT  SHALL   I    EAT? 

or  who  are  exposed  to  frequent  changes  in  the 
weather,  and  to  the  inclemencies  of  an  intolerant 
climate.  Still,  if  there  is  an  inclination  to  ex- 
cessive consumption,  it  is  better  to  enforce  total 
abstinence,  not  only  from  grape  wine,  but  also 
from  all  other  beverages  containing  the  noxious 
and  dangerous  elements  of  alcohol.  Fortunate- 
ly, it  seems  an  established  fact  that  wine-growing 
countries  are  comparatively  free  from  the  rav- 
ages of  alcoholism. 

Apart  from  the  stimulating,  nutritive,  and 
tonic  qualities  which  wine  possesses,  other  very 
valuable  antiseptic  properties  belong  to  it,  of 
especial  merit  to  the  inhabitants  of  countries 
where  the  drinking-water  is  often  bad  and  viti- 
ated. Sabrazis  has  found  that  Eberth's  bacillus 
lives  only  two  hours,  i.  e. ,  in  the  human  body, 
after  partaking  of  red  wine  of  10  per  cent; 
thirty  minutes  after  ingesting  Bourgogne, 
twenty  minutes  after  old  white  wine,  and  ten 
minutes  after  Champagne. 

The  acidity  seems  to  have  a  stronger  reaction 
than  the  alcoholic  content.  Moreover,  by  acid- 
ulating the  drinking-water  with  wine,  about 
twelve  hours  before  using  it,  a  suspected  water 
may  be  purified  and  sterilized.  It  is  an  old  cus- 


WINES  333 

torn,  practised  so  much  in  the  monasteries  and 
colleges  of  former  days,  and  undeservedly  de- 
cried by  modern  authorities. 

Wine  should  not  be  given  to  children  under 
twelve  to  fourteen  years  of  age;  but,  during  the 
period  of  pubescence,  it  will  often  prove  a  useful 
aid  in  overcoming  the  trials  and  troubles  as  well 
as  the  dangerous  complications  of  this  passage. 
From  fifty  to  fifty-five  years  and  upward  the 
daily  ration  must  be  restricted,  as  should  be  the 
case  with  all  stimulating  aliments.  Woman, 
also,  has  every  reason  to  be  more  abstemious 
than  man. 

In  a  number  of  pathological  conditions  wine 
accomplishes  much  good,  but  wisdom  in  the 
proper  choice  is  required,  especially  in  the  elim- 
ination of  fraudulent  and  adulterated  prepara- 
tions. A  good  old  Bordeaux  generally  agrees 
with  convalescents.  In  anemia  and  chlorosis  a 
Bordeaux,  at  least  two  years  old,  will  prove  of 
benefit,  as  it  is  rich  in  iron  and  tannin;  likewise 
in  tuberculosis,  unless  it  is  contraindicated  by 
dyspepsia,  diarrhea,  a  tendency  to  hemoptysis, 
and  congestion.  Diabetics  may  make  fair  usage 
of  dry  wines,  but  must  avoid  the  sweet  brands. 
We  have  already  pointed  out  the  happy  influ- 


334  WHAT  SHALL   I    EAT? 

ence  exercised  by  alcohol  upon  glycosuria  and 
the  digestion  of  fats,  so  important  in  diabetes. 
Gautier  emphasizes  also  with  good  reason  the 
antiscorbutic  properties  of  the  red  wines. 

Another  factor  in  their  favor  is,  also,  that  they 
keep  better  than  the  white  wines.  The  contra- 
indications are  numerous  and  important.  First 
of  all  we  mention  cirrhosis,  especially  in  the  as- 
citic  form  with  portal  hypertension,  which  is,  in 
effect,  one  of  the  more  frequent  complications  of 
vinism.  The  patient  afflicted  with  this  malady 
betrays  a  most  astounding  susceptibility  in  this 
respect.  The  ingestion  of  even  the  most  minute 
quantity  of  wine  often  suffices  to  reawaken 
symptoms  which  lay  dormant  for  months. 

On  the  whole,  wine  is  injurious  in  all  liver 
complaints,  especially  in  the  congestive  forms  of 
arthritis  and  malaria.  In  all  hot  climates,  ab- 
stemiousness in  the  use  of  alcoholic  drinks  is  an 
essential  condition  for  physical  welfare. 

Dyspeptics  rarely  tolerate  wine  in  any  shape 
or  form.  Sweet  wines,  red  wines,  especially  the 
heavier  sorts,  and  the  indiscriminate  use  of  sev- 
eral kinds  of  wine  during  the  same  meal  fre- 
quently account  for  the  trouble.  In  the  lighter 
forms  of  hyper-  or  hypo-chlorhydria  a  small  dose 


WINES  835 

of  white  Bordeaux,  mixed  with  water,  may  be 
allowed.  An  exception  may  be  made  with 
Champagne,  which  possesses  a  special  virtue  on 
account  of  its  large  content  of  carbonic  acid. 
It  is  indicated  in  all  cases  of  gastric  intolerance, 
in  acute  diseases,  affections  produced  by  chloro- 
form, and  in  pregnancy.  It  has  a  tonic  effect 
on  the  organism  worthy  of  our  attention.  Thor- 
oughly iced,  it  is  more  active  than  when  served 
at  the  ordinary  room  temperature. 

In  intestinal  affections  the  use  of  wine  is  lim- 
ited. In  constipation  and  enterocolitis  the  red 
wines,  especially  those  of  high  flavor,  should  be 
avoided. 

In  nervous  diseases,  neurasthenia,  and  hypo- 
chondria, and  mental  affections,  it  is  always  in- 
jurious. It  is  astonishing  how  total  abstinence 
will  often  cause  the  symptoms  to  vanish  rapidly, 
only  to  recur  again  as  suddenly  after  the  slight- 
est indiscretion.  All  these  patients  are  super- 
sensitive  to  every  excess  in  the  diet,  especially 
in  the  use  of  alcoholic  stimulants. 

Wine  is  absolutely  to  be  excluded  from  the 
menu  in  all  cardiovascular  affections,  especially 
in  hypertension,  in  aortitis,  and  in  angina  pec- 
toris.  In  albuminuria  white  wine  is,  perhaps, 


336  WHAT  SHALL   I    EAT? 

less  injurious  than  the  red.  Old  red  Bordeaux 
agrees  with  orthostatic  conditions.  It  is  also 
preferable  in  renal  lithiasis,  as  it  is  less  alcohol- 
ized and  less  acid.  Moselle  and  Bourgogne  wines 
should  be  treated  with  distrust. 

Strict  sobriety  is  also  to  be  prescribed  for  all 
workers  exposed  to  saturnism,  for  alcohol  is 
prone  to  favor  the  frequency  and  gravity  of 
accidents. 

In  gout,  von  Noorden  grants  a  small  allowance 
of  white  wine,  thinned  out  with  water.  Cham- 
pagne is  preeminently  forbidden. 

In  chronic  rheumatism,  neuralgia,  rebellious 
migraine  and  asthma,  abstention  from  wine 
should  always  be  counseled.  The  symptoms 
will  very  often  quickly  disappear.  Skin  dis- 
eases, eczema,  psoriasis,  Jurunculosis,  acne  ro- 
sacea,  all  demand  total  abstinence.  The  evil 
effects  of  wine  on  the  complexion  are  so  well 
known  that  women  of  fashion,  solicitous  about 
their  beauty,  are  wont  to  confine  themselves  to 
the  exclusive  use  of  water  as  a  beverage. 


BEER 

THE  manufacture  of  beer  is  more  complicated 
than  that  of  wine.  Barley,  which  forms  the  or- 
dinary basis,  is  turned  into  malt  by  allowing  it 
slowly  to  germinate  in  vaults  at  50°  F.  Diastase 
is  thus  developed,  which  transforms  the  starch 
into  dextrin  and  maltose.  The  whole  is  then 
dried  in  a  temperature  of  165°  F.,  when  more 
maltose  and  less  dextrin  is  produced.  Under 
these  conditions  the  light,  amber-colored  beer  is 
obtained.  At  225°  F.  the  dark  beer  is  the  result, 
which  contains  less  maltose  but  more  dextrin, 
which  is  not  subject  to  fermentation. 

In  the  process  of  brewing  the  grain  is  filtered 
off  with  water  at  a  temperature  of  160°  F.,  which 
process  carries  with  it  the  diastase,  invertin, 
dextrin,  maltose,  and  albuminoid  matters. 
These  in  their  turn  become  partially  peptonized, 
while  a  large  proportion  of  the  maltose  is 
changed  into  glucose.  When  desiccated,  this 
maltose  furnishes  what  is  known  as  "Malt  Ex- 
tract." 

337 


338  WHAT   SHALL   I    EAT? 

Hops,  in  certain  quantities,  are  added  to  clar- 
ify and  preserve  it  while  giving  the  beer  that 
bitter  taste. 

Fermentation  is  produced  by  the  addition  of 
fresh  yeast,  which  transforms  a  part  of  the  glu- 
cose into  alcohol  and  carbonic  acid.  High 
fermentation  at  a  temperature  of  50°  F.  ensues 
quickly,  and  produces  a  light  beer  or  small  beer; 
low  fermentation  at  40°  F.  or  42°  F.  is  much 
slower,  and  produces  a  heavier  beer,  called 
"lager." 

The  mean  composition  of  beer  is: 

Alcohol  Carbo- 

Albumin.       by  Weight,     hydrates.          Ash.        Chlorid.       Purins.        Calories. 

0.50         3.90         5.9        0.19        0        0.011        50 

Seer  differs  from  wine  by  the  presence  of 
purins,  an  appreciable  amount  of  sugar,  and  a 
small  percentage  of  alcohol,  which  latter  cir- 
cumstance makes  it  a  trifle  less  nourishing,  the 
alimentary  value  being  only  55  to  60  per  cent. 

Besides  these  constituents  beer  contains  a  no- 
table proportion  of  carbonic  acid,  which  makes  it 
sparkling;  also  some  bitter,  resinous,  tonic  sub- 
stance, certain  acids  and  salts,  but  chiefly 
earthy,  alkaline  phosphates. 

1  Porter  contains  0.17  purins. 


BEER  339 

The  dark  brown  beers  are  more  nutritious, 
richer  in  extracts  and  dextrin,  but  poorer  in 
alcohol. 

Malt  Extract  possesses  highly  nutritive  quali- 
ties. Liebe's  preparation  has  the  following 
composition: 

Albumin.  Maltose.  Dextrin.  Calories. 

5  76  16  390 

The  diastasic  ferments  which  it  contains,  ad- 
vance digestion  and  assimilation,  and  are  splen- 
did agents  for  superalimentation. 

The  heavy  English  beers — pale  ale  and  porter 
—exceed  in  the  percentage  of  alcohol  and  purins. 

As  beer  contains  more  water  and  less  alcohol 
than  wine,  its  action  on  our  organs  is  slightly 
more  beneficial.  The  gastric  reaction  is  com- 
pensated for  by  the  presence  of  carbonic  acid 
and  the  hops,  also  by  the  deficit  in  alcohol, 
which  renders  it  very  easy  on  the  stomach. 
Considerable  quantities  may  be  absorbed  with- 
out engendering  any  appreciable  degree  of  gas- 
tric fatigue.  When  consumed  with  the  food,  it 
has  wrongly  been  accused  of  impeding  diges- 
tion. This  is  not  true,  except  in  very  rare 
cases.  But  it  is  well  to  know  that  beer  and 
milk  are  incompatibles.  The  dark  brown  beer 


340  WHAT  SHALL   I    EAT? 

is  always  better  tolerated  than  the  light-colored 
beer.  Beer  is  slightly  intoxicating,  and  may  be 
justly  called  a  non-calorific  beverage.  Yet,  it  is 
benignly  tonic,  diuretic,  and  even  diaphoretic. 
If  drunk  to  excess  it  fatigues  the  heart  and  the 
arteries,  the  liver  and  the  kidneys,  by  producing 
a  surcharge  of  aqueous  infiltration  of  the  organ- 
ism which  may  deteriorate  into  atheroma,  slug- 
gishness of  metabolism,  and  obesity. 

Indications  and  Contraindications. — Beer  de- 
serves the  title  of  hygienic  beverage  even  more 
so  than  wine.  It  nourishes  more  and  alcohol- 
izes less.  Two  liters  of  light-colored  beer  con- 
tain less  alcohol  than  600  c.c.  of  wine,  and 
yet  have  double  the  nourishing  power,  or  more. 
Again,  it  is  much  cheaper  in  price,  and  there- 
fore is  within  the  reach  of  the  poorer  classes. 
It  is  to  be  feared,  however,  that  men  who  per- 
form very  fatiguing  tasks,  not  finding  in  beer 
the  desired  stimulus,  will  fall  back  on  stronger 
concoctions. 

In  pathological  conditions  preference  is  given 
to  dark  malted  beers.  They  certainly  furnish 
an  excellent  drink  to  dyspeptics,  particularly  in 
cases  of  gastritis  of  long  standing,  in  atony, 
tuberculosis,  emaciation,  and  cachexia,  when  wine 


BEER  341 

cannot  be  tolerated,  and  in  nervous  affections. 
Beer  may  be  of  service  in  certain  cases  of  he- 
patic insufficiency  and  intestinal  susceptibility. 
It  is  of  unquestionable  value  to  the  pregnant 
and  nursing  woman,  as  it  stimulates  lacteal  se- 
cretion, apart  from  being  a  food. 

It  does  not  suit  diabetics.  Leo  claims  that 
the  products  of  yeast  fermentation  are  injurious 
to  the  patients.  Neither  does  it  agree  with 
gout,  congestion  of  the  liver,  obesity,  Bright' s 
disease,  albuminuria,  atheroma,  and  cardiac  trou- 
bles. 

The  light-colored  beers  must  be  avoided  by 
dyspeptics,  and  in  all  cases  of  enteritis,  dysen- 
tery, catarrh  of  the  bladder,  and  in  blennor- 
rhagia. 


CIDER 

COMPOSITION    AND    REACTION 

Alcohol 
by  Weight.  Carbohydrates.  Ash.  Calories. 

2.08  3.40  0.20  34 

Cider  is  generally  made  from  a  certain  kind 
of  apples  called  "cider  apples,"  which  are 
crushed,  together  with  a  given  amount  of  water, 
through  a  press.  The  juice,  which  is  drained 
off,  is  again  diluted  by  the  addition  of  one-third 
of  its  quantity  of  water,  and  is  then  allowed  to 
ferment.  The  acids,  in  proportion  slightly  less 
than  in  wine,  are  altogether  of  an  organic  na- 
ture, and  by  combustion  alkalize  the  cider. 

In  this  respect,  and  also  because  its  alcoholic 
content  is  low,1  cider  makes  a  good,  pleasant, 
and  refreshing  drink;  but  it  contains  very  little 
toxicity,  and  is  still  less  calorific  than  beer. 
This  accounts  for  the  sad  fact  that  cider-pro- 

1  This  defect  in  alcohol  is  still  further  increased  by  the  fact 
that  the  peasants,  as  a  rule,  add  yet  more  water  to  the  cider 
set  apart  for  their  own  use,  serving  it  under  the  name  of  "cider 
water." 

342 


CIDER  343 

ducing  districts  pay  such  a  high  tribute  to  alco- 
holism. 

Indications  and  Contraindications. — Cider  re- 
tards gastric  digestion,  and  is  not  fit  for  dyspep- 
tics. Its  purging  propensities  make  it  risky  for 
those  who  are  inclined  to  diarrhea,  but  useful 
in  constipation.  Garros  attributes  to  cider  anti- 
gouty  and  antiuric  properties,  which  accelerate 
the  elimination  of  uric  acid  by  alkalizing  the 
humor,  for  which  reason  he  recommends  it  in 
cases  of  urinary  lithiasis  and  in  gout. 

To  make  sweet  cider  the  apple-juice  is  drawn 
in  bottles  before  it  has  had  time  to  ferment,  and 
left  there  until  it  is  clarified.  This  makes  a 
sparkling  liquid,  full  of  alcohol,  which  easily 
goes  to  the  head.  It  should  be  consumed  in 
small  quantities  only. 


VEGETARIANISM 

IT  would  be  partial  to  wind  up  a  book  of  this 
kind  without  devoting  at  least  a  few  words  to 
the  important  problem  of  vegetarianism.  Since 
Pythagoras  was  one  of  the  first  adepts  in 
its  practice,  it  has  always  been  able  to  boast 
of  a  goodly  retinue  of  partisans.  Nowadays  the 
number  of  adherents  and  enthusiasts  is  on  a 
steady  increase,  especially  in  England  and  Bel- 
gium, countries  in  which  of  yore  the  abusive 
use  of  meat  has  been  most  rampant.  The  move- 
ment is  strong,  and  many  attempts  have  been 
made  to  put  it  on  a  scientific  basis  by  advancing 
its  rational  and  physical  advantages.  In  fact, 
we  have  already  a  formidable  array  of  books, 
pamphlets,  and  treatises  on  the  subject,  which 
are  by  no  means  devoid  of  interest;  but,  on  the 
contrary,  worthy  of  our  attention  and  closer 
study. 

It  is  scarcely  necessary  to  give  here  a  defini- 
tion of  the  meaning  of  the  word  which  implies 
its  purpose,  viz.,  the  restriction  of  our  daily 

344 


VEGETARIANISM  345 

diet  to  foodstuffs  gathered  from  the  vegetable 
kingdom,  to  the  rigid  exclusion  of  animal  foods. 
Such,  at  least,  is  vegetarianism  in  the  strict  sense 
of  the  word;  although  there  is  a  milder  form  in 
which  the  use  of  meat  only  is  eliminated,  while 
milk  and  eggs  still  find  admittance  into  the 
sacred  precincts  of  the  dining-room.  The  term 
"fruitarianism"  is  self-explanatory. 

Vegetarianism  is,  primarily,  a  reaction  ema- 
nating from  the  abusive  use  of  meat  in  contra- 
distinction to  the  wide-spread  belief  that  a  good 
piece  of  savory,  underdone  (rare)  beef  consti- 
tutes the  best  possible  nutriment.  So  far  as 
that  is  concerned,  we  are  free  to  admit  that  an 
excessive  meat  diet  entails  greater  disadvantages 
than  real  alimentary  benefits. 

The  tenets  of  vegetarianism  may  be  thus 
briefly  summed  up: 

1st.  It  is  a  regimen  poor  in  nitrogenous  sub- 
stances, but  rich  in  ternary  bodies,  and  of  un- 
doubted advantage.  It  is  beneficial  to  the 
digestive  organs,  which,  instead  of  being  sub- 
jected to  the  abrupt  and  violent  stimulation  of 
carnal  albumins,  are  exposed  only  to  milk  and 
the  sustaining  action  of  vegetable  substances. 
The  middle  intestinal  regions  are  also  agreeably 


346  WHAT  SHALL   I    EAT? 

affected  by  it,  as  they  are  kept  free  from  ni- 
trogenous elements,  which  form  so  excellent  a 
culture  medium  for  the  intestinal  flora.  The 
kidneys,  too,  are  relieved,  for  a  smaller  amount 
of  residue  is  left  behind  to  be  eliminated. 
Therefore,  the  benefit  accruing  extends  through- 
out the  whole  process  of  digestion. 

The  physical  exertions  required  for  the  proper 
digestion  of  meat  foods  are  minimized  in  the 
vegetable  diet.  The  ternary  bodies  are,  after 
all,  agents  of  economy  in  the  same  manner  in 
which  nitrogen  accumulates  conditions  of  dis- 
assimilation.  Desgrez  claims  that  the  de- 
struction of  albumin  reaches  its  apex  in  the 
meat  diet,  touches  its  lowest  level  in  the  vegeta- 
ble diet,  and  holds  the  golden  mean  in  the  milk 
diet. 

As  a  producer  of  energy,  nitrogen  is  the  equal 
of  the  ternary  bodies.  But  nitrogen  acts  in  a 
blunt,  abrupt  fashion,  and  may  even  cause  a 
waste  of  energy;  while  the  fats  and  carbohy- 
drates free  their  energy  in  a  slow,  progressive 
manner,  and  in  proportion  to  our  bodily  needs. 

It  seems  also  to  be  established  that  vegeta- 
rianism, when  tolerated,  confers  an  increased 
superior  power  of  endurance  when  moral  and 


VEGETARIANISM  347 

physical  efforts  are  required.  In  sporting  exer- 
cises, and,  generally  speaking,  in  endurance 
tests,  vegetarians  have  certainly  proved  them- 
selves superior  to  meat-eaters.  Fauvel  claims, 
from  personal  experience,  to  have  become 
much  more  inured  against  fatigue  since  he 
became  converted  to  vegetarianism.  Lefevre 
insists  upon  increased  resisting  power  against 
cold,  observed  in  himself  and  in  a  number  of 
other  vegetarians.  Moral  advantages  are  by  no 
means  less  conspicuous;  intellectual  occupation 
becomes  easier,  and  brain  work  more  intense; 
the  mind  is  more  cheerful,  and  the  temper  more 
evenly  balanced.  Such  are  the  virtues  claimed 
by  the  vegetarian  school. 

2d.  It  is  a  regimen  poor  in  purins  and,  there- 
fore, less  toxic.  The  purins  contribute  in  a  large 
measure  to  the  toxicity  of  meat.  Their  num- 
berless misdeeds  have  been  thoroughly  studied 
by  the  vegetarians,  especially  by  Haig,  whose 
work  we  deem  it  profitable  here  to  review  in 
brevity. 

In  meat-eaters  he  finds  an  overproduction  of 
uric  acid,  and  also  a  retention  by  reason  of  hu- 
moral acidity,  which  inhibits  elimination.  This 
excess  of  uric  acid  retards  the  circulation  by  its 


348  WHAT  SHALL   I    EAT? 

vaso-astringent  action,  and  may  also  increase 
the  viscosity  of  the  blood;  it  engenders,  likewise, 
the  sluggishness  and  the  physical  and  moral 
torpidity  so  often  observed  in  heavy  meat-eaters. 
A  fresh  repast  of  nitrogenous  food  may  well,  by 
raising  the  amount  of  acidity  and  precipitating 
the  uric  acid  into  the  tissues,  produce  a  momen- 
tary sensation  of  comfort;  but  this  does  not  en- 
dure and  soon  makes  room  for  a  corresponding 
feeling  of  depression.  The  need  for  nitrogenous 
ingestion  increases  in  a  similar  manner  as  the 
craving  for  alcoholic  stimulants  becomes  ever 
more  exacting  in  those  addicted  to  drink. 

Such  is  the  beginning  and  the  course  of  this 
phase  of  diet.  The  accumulation  of  uric  acid 
is  incessantly  heaped  up;  and,  ere  long,  morbid 
symptoms  manifest  themselves.  These  charac- 
terize the  second  phase,  marking  a  still  higher 
degree  of  intoxication,  the  modality  of  which 
depends  on  individual  reaction.  Migraine  may 
serve  here  as  a  typical  example  for  demonstra- 
ting how  Haig  explains  the  affiliation  of  un- 
toward events.  According  to  him,  migraine  is 
due  to  a  sharp  crisis  of  alkalinity  of  the  blood 
arising  from  toxic  substances;  uric  acid  now  en- 
ters the  circulation  in  large  quantities,  "the 


VEGETARIANISM  349 

small  blood-vessels  are  contracted,  the  skin  is 
chilled,  vascular  tension  increased,  secretion  of 
urine  diminished,  the  nerve-cells  are  shocked, 
moral  force  is  weakened,  and  intellectual  power 
becomes  clouded. " — (loteiko. ) 

By  analogous  deductions  he  attributes  a 
whole  mass  of  diseases  to  this  accumulation  of 
uric  acid  in  the  system,  viz. :  epilepsy,  asthma, 
hysteria,  dyspepsia,  hemoglobinuria,  anemia, 
albuminuria,  diabetes,  cardiac  defects,  etc. 

Gout  and  lithiasis  are  the  last  phases  of  this 
condition,  the  last  degree  of  accumulation  of 
uric  acid,  the  surest  symptom  in  an  unmista- 
kable diagnosis  of  uricemia.  This  is  Haig's  the- 
ory. In  certain  regards  it  is,  perhaps,  somewhat 
exaggerated;  but,  by  therapeutic  experiments, 
he  proceeds  to  prove  its  truth.  These  he  based 
upon  a  diet  capable  of  reducing  the  production 
of  uric  acid.  Now,  as  there  is  a  number  of  veg- 
etable aliments  which  contain  xanthic  bodies, 
such  as  legumes,  asparagus,  mushrooms,  beer, 
tea,  cocoa,  coffee,  Haig  advocates  a  special  vege- 
table regimen  which  might  be  called  antiuric, 
in  which  all  these  substances  are  prohibited,  but 
the  use  of  milk  and  eggs  is  permissible. 

3d.  It  is  a  regimen  more  mineralizing  than 


350  WHAT   SHALL   I    EAT? 

any  other.  The  proportion  of  ash  is  undoubt- 
edly higher  in  vegetables,  and  green  vegeta- 
bles, especially,  are  ten  times  as  much  miner- 
alized as  meat. 

4th.  It  is  a  regimen  very  rich  in  cellulose,  and, 
by  reason  of  a  superabundance  of  residue,  better 
adapted  to  prevent  constipation  and  intestinal 
stasis. 

5th.  It  is  more  hygienic,  because  certain  vege- 
tables (dried  legumes)  and  fruits  are  easier  to 
keep,  and  not  so  readily  subject  to  change. 
Moreover,  disease  is  rarely  transmitted  from  the 
vegetable  kingdom. 

6th.  It  is  the  least  expensive  diet.  This  side 
of  the  social  question  is  of  great  importance,  and 
has  been  dealt  with  in  a  very  able  manner  by 
Professor  Landouzy,  by  Marcel,  and  Henri 
Labbe.  Meat  is  expensive,  and  contains  but  lit- 
tle nourishment.  Legumes  and  cereals  are  com- 
paratively cheap,  and  full  of  nutriment. 

*  * 

* 

These  are  the  principal  claims  advanced  by 
the  disciples  of  vegetarianism.  It  remains  now 
for  us  to  expose  the  possible  fallacies  contained 
in  this  doctrine,  and  to  point  out  the  objection- 
able features.  This  we  shall  do  by  showing  un- 


VEGETARIANISM  351 

der  what  conditions  a  vegetable  diet  may  prove 
profitable,  or,  on  the  contrary  injurious,  to  the 
health  of  man. 

The  first  objection  is  that  it  jades  the  diges- 
tive organs  and  causes  discomfort  and  tension. 
It  lacks  nearly  all  the  stimulating  qualities  con- 
tained in  meat.  To  give  an  equivalent  value 
of  calories,  a  much  larger  volume  of  food  is  re- 
quired, which  produces  a  feeling  of  fulness  and 
overloads  the  digestive  apparatus,  while  absorp- 
tion is  imperfect. 

The  vegetable  albumins  are  tougher,  and  re- 
sist the  attack  of  the  gastric  juices  much  longer. 
Pauloff  has  demonstrated  that,  for  instance,  the 
nitrogen  contained  in  milk  imposes  a  much 
heavier  task  on  the  stomach,  as  well  as  on  the 
intestines,  than  the  animal  nitrogen;  and  bread 
does  still  more  so. 

These  observations  possess  a  great  deal  of 
force,  and  command  our  careful  consideration. 
It  is  a  matter  of  common  knowledge  that  per- 
sons who  follow  a  rigid  vegetable  diet  suffer 
greatly  from  dyspepsia,  distention  of  the  stom- 
ach, abdominal  pressure,  and  intestinal  flatu- 
lency. The  partisans  of  this  reform  do  not  take 
the  trouble  of  denying  the  existence  of  these 


352  WHAT  SHALL   I    EAT? 

< 

evils,  but  they  make  strenuous  efforts  to  prevent 
the  mischief.  In  the  first  place,  they  seek  to 
dimmish  the  percentage  of  albumin;  then  their 
advice  is  to  protract  the  meals  and  eat  the  vege- 
tables in  slow  and  easy  stages;  to  masticate  with 
better  care,  thus  reducing  the  surcharge  of 
liquid  content  and  the  volume  of  the  food;  and, 
finally,  to  make  successive  attempts  with  inter- 
ruptions, when  passing  from  the  meat  diet  to 
the  vegetable  regimen,  thus  giving  the  stomach 
and  the  canal  proper  time  for  adapting  them- 
selves to  the  new  habit.  Judicious  though  these 
precautions  may  be,  we  do  not  believe  that  they 
are  adequate  to  make  everybody — the  fragile 
and  strong — accustomed  to  a  strictly  vegetable 
diet.  On  the  contrary,  we  are  of  the  opinion 
that  many  persons  with  a  weak  and  delicate 
stomach,  with  "civilized"  intestines,  or  a  "busi- 
nessman's" digestion,  will  readily  agree  with 
our  objections. 

A  purely  vegetable  regimen  fails  to  supply 
the  organism  with  the  necessary  vascular  and 
nervous  tonicity.  A  decrease  in  alimentary 
stimulation  must  needs  impair  the  vital  func- 
tions of  the  digestive  glands.  If  this  is  true  in 
certain  morbid  conditions,  it  applies  to  the 


VEGETARIANISM  353 

healthy  being,  just  as  well.  =  The  resisting  power 
against  disease  is  also  weakened.  According  to 
Ewald,  the  percentage  of  sickness  and  mortality 
among  the  prisoners  who  are  kept  on  a  rigid 
vegetable  regimen  is  much  higher.  Excessive 
deprivation  of  tone  and  excitation  is  prejudicial 
to  our  modern  surroundings,  and  does  not  agree 
with  the  exigencies  of  a  strenuous  life.  We  all 
have  to  undergo  hardships  and  perform  fatigu- 
ing tasks  for  which  a  certain  amount  of  stimu- 
lation is  required,  which,  however,  cannot  be 
found  in  a  vegetable  diet. 

Moreover,  as  vegetables  have  to  be  ingested 
in  large  quantities,  they  carry  with  them  into 
the  system  also  an  undue  amount  of  lime,  which 
surcharge  may  become  the  hatching  ground  for 
chronic  rheumatism  and  atheroma. 

So  far  as  rheumatism  is  concerned  this  danger 
is,  perhaps,  only  imaginary,  despite  the  fact 
that  it  is  strongly  in  evidence  among  herbivor- 
ous individuals,  because  it  is  rather  due  to  the 
action  of  hyperacidity,  which  impedes  the  excre- 
tion of  phosphate  of  lime;  and  that  defect  seems 
to  be  rather  corrected  by  a  vegetable  regimen. 
As  regards  atheroma,  however,  the  objection  as- 
sumes a  serious  aspect.  —  (Loeper  and  Boveri. ) 


354  WHAT  SHALL   I    EAT? 

Of  course,  a  wise  choice  among  the  vegetable 
foods  is  always  possible  when  this  dangerous 
condition  is  threatened;  for  instance,  legumes, 
cabbage,  spinach,  carrots,  rye,  and  oats  might 
be  eliminated  from  the  diet,  while  the  other 
cereals,  also  potatoes,  rice,  pastry,  a  number  of 
green  vegetables,  fresh  fruits,  and  nuts — all  poor 
in  lime,  yet  rich  enough  in  food  value — still 
remain  available. 

Nevertheless,  the  last  two  objections  are  by 
no  means  definite  or  conclusive.  But  those 
mentioned  at  first  should  always  be  taken  into 
serious  consideration  when  an  opinion  must  be 
given  on  the  opportuneness  of  a  vegetable  regi- 
men. 

That  vegetarianism  possesses  great  virtues  in 
certain  pathological  conditions  is  now  generally 
admitted  even  by  those  who  do  not  approve 
of  it  for  the  normal  human  being,  particularly 
in  cases  of  arthritis,  unless  it  disagrees  with 
the  patient,  which  is  often  enough  the  case  in 
hereditary  arthritis,  especially  in  the  second  and 
third  generation,  when  the  digestive  tube  is  too 
delicate  and  weakened  to  get  used  to  it.  But 
the  heavy  eater,  the  "bon  vivant, "  who  has 
poisoned  his  constitution  by  excesses,  is  well  ad- 


VEGETARIANISM  355 

vised  if  he  adopts  a  vegetable  diet,  which, 
unless  it  is  already  too  late,  will  improve  his 
health  and  prolong  his  life. 

Other  morbid  conditions  akin  to  arthritis  will 
also  be  benefited  by  it,  always  on  the  condition 
that  the  organism  is  strong  enough  to  support 
it.  To  this  class  belong  those  who  suffer  from 
fatty  degeneration  of  the  liver,  neurasthenic  hy- 
pertension, migraine,  rheumatic  affections,  neu- 
ralgia, and  rebellious  sciatica.  Urinary  lithiasis 
is  also  an  indication;  but  the  biliary  form  is  an 
exception.  —  (Martinet ) 

As  for  gout,  opinions  differ.  Maurel  and 
De  Grandmaison  recommend  a  vegetable  diet. 
Garrod,  Ebstein,  Cantani,  von  Noorden,  allow 
meat  in  small  quantities.  Von  Noorden's  con- 
tention is  that  meat  assists  in  eliminating  uric 
acid  by  reason  of  the  thymic  acid  which  it  al- 
ways contains. 

In  many  skin  diseases  a  vegetable  diet  is  also 
a  great  boon.  Eczema,  acne  rosacea,  and  psori- 
asis often  yield  to  it  when  external  remedies 
have  failed. 

In  Bright' s  disease  and  albuminuria  of  certain 
standing,  a  vegetable  diet,  with  milk,  eggs,  and 
cheese,  often  gives  satisfactory  results. 


356  WHAT  SHALL   I    EAT? 

The  same  may  be  said  of  liy posy  stole,  myocar- 
ditis, and  all  ailments  attended  by  insufficiency 
of  the  orifice.  All  these  require  foods  of  easy 
digestion;  and  a  strict  vegetarianism  imposes 
upon  the  heart  and  intestines  an  extra  amount 
of  activity,  both  useless  and  dangerous.  In 
scleroma.,  hypertension,  aortitis,  and  angina,  a 
vegetable  regimen  may  be  recommended  with 
advantage;  but  milk  must  be  allowed  under  all 
circumstances,  as  it  agrees  with  the  patient  bet- 
ter than  any  other  food. 

In  digestive  affections  it  is  rarely  indicated. 
Exceptions  are:  chronic  constipation,  hemorrhoids, 
and  hyperchlorhydria,  in  which  it  may  assist  in 
inhibiting  gastric  secretion.  But  the  opinions 
are  divided  on  this  subject.  A.  Robin  is  strong- 
ly in  favor  of  meat  in  hyperchlorhydria.  We 
add  also  enter ocolitis,  but  only  in  its  graver 
forms.  The  famous  regimen  of  Combe  is  said 
to  be  of  a  vegetarian  character. 

"Vegetarianism  presupposes  an  absolute  in- 
tegrity of  functional  energy.  It  does  not  suit 
constitutions  weakened  by  hereditary  taint,  by 
disease  or  old  age;  neither  does  it  agree  with 
weak  stomachs. ' ' 

This  phrase  of  Professor  A.  Gautier  comprises 


VEGETARIANISM  357 

all  the  contraindications  of  vegetarianism.  It 
points  out  in  unequivocal  terms  all  the  condi- 
tions in  which  it  is  not  only  unserviceable,  but 
really  dangerous,  viz. :  tuberculosis,  which  re- 
quires the  largest  possible  food  value  in  the 
smallest  possible  volume;  dyspepsia  by  insuffi- 
ciency, intestinal  atony,  and  ptosis,  all  of  which 
require  a  stimulating  diet  combined  with  the 
least  possible  encumbrance — women  worn  out  by 
pregnancy  and  nursing,  all  those  who  have  to 
build  up  lost  tissue  and  require  feeding  up,  or 
who  lack  digestive  or  general  tonicity. 

If  we  pass  from  the  pathological  domain  into 
that  of  physiology,  the  question  at  once  arises: 
Is  vegetarianism,  under  all  circumstances,  ap- 
plicable and  beneficial  to  every  human  being  in 
perfect  health  ?  We  do  not  believe  it.  Man  has 
ever  been  omnivorous.  The  oldest  customs — the 
very  structure  of  his  digestive  apparatus — prove 
that  the  mixed  diet  is  the  most  suitable.  This 
is  preeminently  true  in  respect  to  the  growing 
youth.  In  the  period  of  formation  and  develop- 
ment, animal  food  is  a  matter  of  necessity. 
For  the  full-grown  adult  we  must  make  a  dis- 
tinction. Sigaud  divides  the  human  race  into 
two  classes — the  strong  and  the  weak.  The 


358  WHAT  SHALL   I    EAT? 

latter  cannot  afford  to  eschew  the  tonic  stimula- 
tion of  meat.  The  former  thrive  sometimes  on 
a  vegetable  diet. 

In  summing  up  we  will  admit  that  vegeta- 
rianism is  an  excellent  regimen  for  many,  but 
it  does  not  suit  all.  A  modified  vegetable  diet, 
that  which  includes  eggs  and  milk,  appeals  to 
us  as  more  rational  and  suitable  for  many  indi- 
vidual cases. 

In  conclusion,  we  do  not  hesitate  to  borrow 
another  notable  phrase  culled  from  Professor  A. 
Gautier's  book: 

"A  system  of  modified  vegetarianism  should 
gradually  eliminate  the  fierce  and  rugged  ele- 
ments from  man's  character,  and  fill  the  earth 
with  gentle  manners.  It  is  both  feasible  and 
rational,  and  should  appeal  to  and  be  practised 
and  advocated  by  all  who  seek  the  ideal  life  and 
aim  at  producing  a  sweet-tempered,  intellectual, 
and  artistic,  yet  vigorous,  active,  and  prolific 
race. ' 


COMPARATIVE  TABLE 


OF 


ALIMENTARY  PROPORTIONS 


Carbo- 
Albumin     Fats     hydrates     Ash       Water 


Beef 

Veal 

Mutton  

iffr"     -.,     "••\~~                 7             •--=-"_::_-               j 

Pork  
Liver  

?§-<%  '^^'-  rr  r^  j 

Kidney  

y^mmM\ 

Sweetbreads       • 

lililiipilliil 

Brain  
Marrow  

Cervelat  sausage 
Sausages  (small) 
Goose-liver  

Chicken  

^ 

Pigeon  

Rabbit  

Duck  

Turkey  

_^ 

Goose                 .  . 

^^^^^M^L                  ,     —  -  —  ==:  4 

//x/       ^/y/y/tjZt'           ~  —  :  r   -—•-'-'-    --~---~^ 

Quail  

^  ^^^^1 

Partridge  

^^^^^^^^H 

Venison  

%MiiiM2%%i%=\ 

Coalfish  

W%%y/% 

Codfish  

%•/    '-W^Mi^^^. 

Trout  

mmM^A-^ 

Sardines  (in  oil) 

Herring  

Salmon  

^^^^^^^^-^=-\ 

Egg  

^^^^^g=^E| 

Yolk  of  egg  

^^^^^%—--  ?s->----^  =~  ;^  ^-  J 

Milk  

^K^j 

Swiss  cheese.... 
Butter  I 

^^-  —  -^  

360 


Carbo- 
Albumin     Fats     hydrates     Ash 


Water 


Beef 

Barley 

Oats 

Rice 

Maize 

Rye 

Buckwheat 

Wheat 

Bread 

Macaroni 

Lentils 

White   beans.... 

Dried  peas 

Potatoes 

Cabbages 

Onions 

Carrots 

Turnips 

Cress  

Spinach 

Tomatoes 

Mushrooms 

Apricots 

Cherries 

Lemons 

Quinces 

Strawberries. . . . 

Oranges  

Peaches 

Apples 

Pears 

Plums 

Grapes 

Bananas 

Dates 

Figs  (dry) 

Almonds  (dry) .. 

Hazlenuts 

Walnuts   (dry).. 


-^ 


E33C 


361 


GLOSSARY 


DEFINITIONS   OF   TECHNICAL   TERMS 

Acetonuria — The  presence  of  acetones  in  the  urine. 

Acne — Inflammation  of  the  sebaceous  glands. 

Adynamia — Deficiency  or  loss  of  vital  or  muscular  power. 

Albumin — A  proteid  substance,   the  chief  constituent  of  the 
body. 

Albuminoids— Substances  resembling  true  proteids  in  their  ori- 
gin and  composition. 

Albuminuria — The  presence  of  albumin  in  the  urine. 

Albumose — A  substance  formed  from  albuminoids  during  diges- 
tion. 

Alkaloid — Resembling  an  alkali. 

Amid — A  chemical  compound  produced  by  the  substitution  of 
an  acid  radical  for  one  of  the  hydrogen  atones  of  ammonia. 

Amin — From  ammonia. 

Amydin — Soluble  starch. 

Amylolitic — Pertaining  to  or  effecting  the  digestion  of  starch. 

Anabolism — The  process  of  changing  food  into   constructive 
tissue. 

Anorexia — Absence  or  diminution  of  appetite. 

Antitoxic — Counteracting  poison. 

Aortitis — Inflammation  of  the  aorta. 

Aplastic — Structureless ;  not  able  to  form  tissue. 

Arthritis — Inflammation  of  a  joint. 

Assimilation — The  process  of  transforming  and  absorbing  food 
in  the  organism. 

Asthenia — General  loss  or  absence  of  strength. 

Asystole — Imperfection  of  the  heart's  action. 

Atheroma — Tumor. 

Atonia — Want  of  tone  ;  debility. 

Atrophy — A  deterioration  of  parts  originally  normal. 

Azoturia — Increase  of  urea  and  urates  in  the  urine. 

363 


364  GLOSSARY 

Blennorrhagia — An  excessive  catarrhal  discharge  from  the 
urethra  or  vagina. 

Cachexia — Depraved  condition  of  nutrition. 

Calory — A  heat  unit. 

Carbohydrate — An  organic  substance  containing  oxygen  and 
hydrogen  in  the  proportion  in  which  they  form  water. 

Cardiopathy — Any  disease  of  the  heart. 

Casein — A  derived  albumin. 

Catabolism — Destructive  action  of  the  organism.  (See  Disas- 
similation. ) 

Cecal — Relating  to  the  cecum. 

Cecum— The  large  blind  pouch  in  which  the  large  intestine 
begins. 

Cellulose— The  primary  substance  of  organic  cell-walls. 

Chlorin — A  non-metallic  element. 

Chlorosis — The  "Green  Sickness." 

Cirrhosis — Increase  and  thickening  of  the  connective  tissue  of 
an  organ,  especially  of  the  liver. 

Coefficient — An  agent  that  unites  its  action  with  that  of  an- 
other agent  for  the  procuring  of  a  certain  result. 

Colitis — Inflammation  of  the  colon. 

Collagen — A  substance  existing  in  various  tissues  of  the  body. 

Coma — Abnormally  deep  and  prolonged  sleep,  with  the  func- 
tions of  the  brain  in  abeyance. 

Combustion — The  burning  up  of  food  by  bodily  heat  in  the 
organism. 

Creatin — A  neutral  organic  substance  that  occurs  in  the  animal 
organism,  especially  in  the  juice  of  the  muscles. 

Cystin — A  substance  found  in  the  urine  in  small  amount. 

Cystitis — Inflammation  of  the  bladder. 

Depuration — Cleaning. 

Dextrin— The  soluble  or  gummy  matter  into  which  starch  is 

converted  by  diastase  or  by  certain  acids. 
Diabetes — The  sugar  disease. 
Diaphoretic — Sudorific  ;  producing  sweat. 
Diastase — A  nitrogenous  vegetable  ferment. 
Diathetic — Liable  to  certain  diseases. 
Dietetics — The  science  of  systematic  regulation  of  the  diet  for 

hygienic  and  therapeutic  purposes. 


GLOSSARY  365 

Disassimilation — Decomposition   and  rejection   of  undigested 

food  substances.     Non-absorption. 
Diuresis — Abnormal  increase  in  the  secretion  of  urine. 
Dulcite — An  hexahydric  alcohol. 
Dyspnea— Difficult  or  labored  breathing  due  to  disease. 

Endogenetic — Due  to  internal  causes. 

Enteritis — Inflammation  of  the  small  intestine. 

Enterocolitis— Inflammation  of  the  small  intestine  and  of  the 
colon. 

Enteroptosis — Relaxation  of  the  abdominal  viscera. 

Epithelium — The  cuticle  of  a  mucous  surface  and  of  the  skin. 

Etiology — Causes  of  diseases. 

Euphoria— The  feeling  of  well-being  or  health. 

Exogenetic — Due  to  external  causes. 

Extractives — Substances  extracted  from  various  animal  tis- 
sues. 

Fecula— The  starchy  part  of  a  seed. 
Ferruginous — Containing  iron. 
Flora— Plant  life. 

Galactose — Lactose. 

Gasterectasis — Dilatation  of  the  stomach. 

Gastritis — Inflammation  of  the  coating  of  the  stomach. 

Glucose — Grape-sugar,  starch-sugar. 

Gluten — A  substance  resembling  albumin. 

Glycogen — Animal  starch. 

Glycosuria — The  presence  of  grape-sugar  in  the  urine. 

Hemoptysis — The  spitting  of  blood. 
Humoral — Pertaining  to  the  natural  fluids  of  the  body. 
Hydration— The  impregnation  of  a  substance  with  water. 
Hyperchlorhydria — Excess  of  hydrochloric  acid  in  the  gastric 

secretion. 
Hypertension — Abnormally  high  tension.     Same  as   superten- 

sion. 

Hypertrophic — Marked  by  excessive  size. 
Hypopepsia — Disorder  of  digestion. 
Hypostenia — Weakness. 
Hyposystole — Deficiency  of  cardiac  systole. 
Hypotension — Abnormally  low  tension.    Lowered  or  diminished 

tension. 


366  GLOSSARY 

Icterus  —Jaundice. 

Ingestion — The  partaking  of  food. 

Inosite — A  saccharine  substance  in  the  human  body. 

Inulin — A  vegetable  principle. 

Invertin — A  ferment  found  in  the  intestinal  juice. 

Isodynatnic — Having  equal  force. 

Lactose — Milk-sugar. 

Lecithin — A    complex    nitrogenous    fatty    substance    present 

throughout  the  animal  body. 
Leucin — A  product  of  pancreatic  digestion. 
Leukomain — Nitrogenous  bases  or  alkaloids  developed  by  our 

vital  functions. 

Levulose — The  natural  sugar  of  fruits. 
Lithiasis — The  formation  of  calculi  (stone). 

Malate — A  salt  of  malic  acid  (found  in  unripe  apples,  grapes, 

etc.). 

Maltose — A  variety  of  sugar  found  in  beer. 
Mannite — The  exudation  of  the  flowering  ash. 
Metabolism — The  natural  changes  constantly  taking  place  in 

the  cells  of  the  human  body. 

Myocarditis — Inflammation  of  the  muscular  tissue  of  the  heart. 
Myosin — The  chief  proteid  of  the  muscle. 

.Nephritis — Inflammation  of  the  kidneys. 

Neurasthenia — Nervous  affections. 

Nuclein — A  substance  that  occurs  in  the  nuclei  of  the  cells. 

Olein— A  natural  fat. 
Oliguria — Diminution  of  urine. 

Oxaluria — Presence  of  calcium  in  the  urine  in  undue  propor- 
tions. 

Pancreatin — The  active  elements  of  the  juice  of  the  pancreas. 
Parenchyma— Soft  cellular  tissue. 
Pathogenic — Producing  disease. 

Pathological — Abnormal,  diseased  conditions  of  the  body. 
Peptone — A  proteid  body  produced  by  the  action  of  digestion. 
Periosteum — A  fibrous  membrane  that  invests  the  surfaces  of 
the  bones. 


GLOSSARY  367 

Peristalsis— The  peculiar  movements  of  the  intestines  which 
propel  the  contents  onward. 

Physiological — Pertaining  to  the  natural  or  normal  processes  of 
the  healthy  body. 

Proteids — A  general  term  for  the  albumin  and  albuminoid  con- 
stituents of  the  organism. 

Psoriasis — An  inflammatory  disease  of  the  skin. 

Psychic — Pertaining  to  the  mind  or  sential  principles. 

Ptomains — Inanimate  poisonous  substances  resulting  from 
putrefaction  of  albuminous  substances. 

Ptosis — Drooping. 

Puric— Belonging  to  purins. 

Purins — Unclean  or  poisonous  substances,  foreign  to  our  ali- 
mentary organism. 

Pylorus — The  opening  of  the  stomach  into  the  duodenum. 

Pyrexia — Fever 

Saccharose — Cane-sugar. 

Sclerosis — Overgrowth  of  the  connective-tissue  of  an  organ. 

Silica — The  oxid  of  silicon. 

Solanin — A  glucosid. 

Stasis — A  condition  of  standstill. 

Steapsin — A  diastasic  ferment. 

Stenosis— Constriction  or  narrowing  of  any  part. 

Stomatitis — Inflammation  of  the  mouth. 

Supertension — See  hypertension. 

Ternary  bodies — The  fats,  albumins,  and  carbohydrates  of  any 

food. 

Therapeutics — The  application  of  remedies  as  a  means  of  cure. 
Toxic — Poi  sonou  s. 
Tyrosin— A  decomposition  product  of  proteids. 

Urea — The  chief  solid  constituent  of  the  urine. 

Uremia — Retention  in  the  blood  of  excrementitious  substances 

normally  excreted  by  the  urine. 
Uropoieses — The  neutralization  of  toxic  matter. 

Xanthic — Pertaining  to  xanthin— yellowish. 
Xanthin — A  leukomain  found  in  nearly  all    the  tissues   and 
liquids  of  our  economy — yellow  coloring  matter. 


ANALYTICAL  TABLE  OF  DISEASES 

NOTE. — This  table  contains  only  a  list  of  the  principal  diseases  referred  to  in 
the  book,  indicating  the  number  of  page  on  which  the  diet  affecting  the  disease 
is  mentioned. 

Acne,  149,  290,  300,  336,  355 
Albuminuria — see  Nephritis 
Anemia,  56,  78,  89,  130,  163,  164,  203,  214,  216,  224,  244,  250, 

252,  254,  266,  288,  333 
Angina,  39,  73,  300,  335,  356 
Aortitis,  39,  73,  335,  356 
Arteriosclerosis,  122 
Arthritis,  39,  41,  42,  43,  51,  52,  58,  60,  67,  73,  84,  89,  107,  122, 

124,  133,  138,  140,  148,  154,  162,  165,  193,  202,  205,  215,  217, 

224,  225,  242,  245,  247,  250,  252,  253,  254,  262,  264,  267,  277, 

281,  290,  300,  307,  334,  354 
Atheroma,  73,  250,  252,  266,  294,  341,  353 
Atony,  72,  120,  149,  163,  243,  266,  290,  293,  340,  357 

Blennorrhagia,  246,  248,  250,  251,  294,  341 

Bright's  Disease,  58,  60,  67,  78,  86,  89,  112,  123,  135,  137,  140, 
163,  172,  201,  202,  205,  215,  224,  307,  311,  355 

Cancer,  78,  92,  119,  124,  164 

Cardiovascular — see  Heart 

Cirrhosis,  41,  53,  122,  148,  319,  334 

Coma,  36,  243,  265 

Congestion — see  Plethora 

Constipation,  163,  202,  252,  267,  268,  276,  307,  335,  343,  356 

Consumption— see  Tuberculosis 

Convalescence,  35,  51,  53,  55,  63,  72,  89,  172,  224,  244,  306,  333 

Cystitis,  47,  248,  251,  294 

Demineralization,  55,  163,  244,  252 

Diabetes,  36,  87,  125,  138,  140,  146,  147,  164,  174,  192,  202,  203, 
205,  215,  217,  225,  239,  242,  247,  249,  250,  253,  264,  271,  272, 
274,  278,  280,  291,  292,  293,  307,  326,  334,  341 
369 


S70     ANALYTICAL  TABLE   OF   DISEASES 

Diarrhea,  38,  120,  163,  202,  244,  266,  267,  269,  270,  274,  334,  343 

Dilatation,  120,  163,  204,  214,  215,  243,  266 

Dysentery,  130,  163,  176,  341 

Dyspepsia,  37,  47,  51,  61,  63,  66,  72,  78,  84,  86,  89,  92,  140,  149, 
163,  172,  176,  191,  201,  202,  203,  206,  214,  215,  216,  222,  224, 
238,  243,  246,  247,  249,  250,  252,  253,  254,  260,  266,  270,  271, 
273,  274,  278,  281,  287,  300,  302,  334,  341,  356,  357 

Eczema,  47,  58,  60,  67,  86,  89,  140,  149,  202,  252,  272,  336,  355 
Emaciation,  51,  130,  164,  224,  288,  340 
Enteritis,  38,  66,  78,  127,  130,  137,  214,  215,  231,  266,  341 
Enterocolitis,  39,  66,  78,  121,  137,  140,  163,  202,  204,  214,  244, 

254,  268,  269,  274,  335,  356 
Enteroptosis,  39,  124 

Fevers,  63,  147,  175,  265,  293,  320 

Gastritis,  37,  38,  74,  76,  119,  120,  130,  201,  214,  231,  243,  248, 

254,  293,  335,  340 
Glycosuria,  92,  276,  334 
Gout,  43,  51,  52,  58,  73,  86,  125,  128,  148,  165,  215,  225,  242,  245, 

246,  252,  254,  255,  264,  272,  273,  287,  291,  300,  307,  341,  343 
Gravel,  215,  272,  307 

Heart,  39,  58,  67,  73,  78,  86,  89,  122,  131,  137,  140,  163,  172,  201, 
205,  215,  224,  244,  246,  247,  255,  265,  288,  300,  307,  311,  335, 
341,  356 

Hyperchlorhydria,  37,  76,  84,  92,  120,  130,  149,  163,  179,  215, 
243,  252,  254,  266,  287,  288,  294,  334,  356 

Hypertension,  39,  42,  67,  73,  122,  288,  300,  334,  335,  356 

Icterus — see  Jaundice 

Intestinal  Affections,  58,  86,  125,  128,  130,  149,  163,  192,  193, 
201,  224,  238,  244,  247,  266,  269,  294,  335,  341 

Jaundice,  53,  294 

Kidneys,  54,  72,  131,  243,  244,  246,  294 

Lithiasis,  36,  41,  43,  122,  125,  148,  264,  276,  294,  336,  343,  355 
Liver,  39,  41,  43,  49,  53,  58,  67,  86,  121,  128,  140,  148,  165,  202, 

215,  217,  225,  242,  246,  247,  248,  249,  252,  272,  276,  288,  291, 

294,  300,  341 


METRIC   WEIGHTS   AND   MEASURES     371 

Malaria,  41,  334 
Migraine,  215,  336,  355 

Nephritis,  40,  47,  49,  51,  54,  85,  122,  247,  248,  252,  255,  265,  287, 

335,  341,  355 

Nervous  affections,  39,  41,  74,  123,  130,  149,  300,  335,  341 
Neuralgia,  215,  336,  355 
Neurasthenia,  42,  53,  63,  67,  164,  214,  300,  335,  355 

Obesity,  37,  84,  86,  148,  175,  202,  205,  215,  225,  281,  291,  341 
Oxaluria,  125,  179,  217,  250,  252,  273,  303,  307 

Phthisis — see  Tuberculosis 
Plethora,  73,  131,  272,  276 

Rheumatism,  215,  264,  271,  317,  336,  353,  355 

Skin,  140,  149,  202,  244,  248,  265,  272,  290,  336,  355 
Stone,  52,  73,  86,  128,  277 

Tuberculosis,  35,  51,  53   67,  72,  76,  78,  87,  89,  92,  130,  140,  146, 
147,  164,  172,  205,  214,  244,  254,  266,  277,  287,  293,  340,  357 

Ulcers,  51,  77,  120,  130 
Uremia,  40,  47,  51,  52,  73,  86 
Uricemia,  43,  217,  242,  264,  277,  300,  307 

Vomiting,  76,  778  788  120 


APPROXIMATE   EQUIVALENTS  OF 
METRIC  WEIGHTS  AND   MEASURES 

One  gram  is  equal  to  about  fifteen  grains. 
One  kilogram  is  a  little  more  than  two  pounds. 

One  c.c.,  or  one  cubic  centimeter,  is  equal  to  16.9  minims  or 

drops. 

3.54  cubic  centimeters  =  one  fluid  drachm 
28.35  cubic  centimeters  =  one  fluid  ounce. 
567  cubic  centimeters  =  one  pint. 
4536  c.c.  =  4.536  liters  =  one  gallon. 


INDEX 


INDEX 


Absinth,  323 
Adenin,  21 
Alcohol,  317 

a  food,  321 

a  nervine,  321 
Alcoholic  beverages,  316 
Aliment,  definition  of,  4 
Alimentary  proportions,  360 
Alimentation,  ration  of,  5 
Allspice,  292,  293 
Almonds,  279 
Alsatian  wines,  327,  328 
Amylodextrin,  210 
Analysis,  cryoscopic,  of  milk, 

109 

Anchovies,  292 
Anisette,  323 
Aperients,  323 
Apple-Jack,  323 
Apples,  257,  273 
Apricots,  257,  269 
Arrowroot,  227 
Artichokes,  245 
Asparagus,  245 
Aubergine,  253 

Baby  foods,  228 
Bananas,  278 
Barley,  175 
Barnyard  meats,  61 
Bass,  80 
Bayberries,  260 
Bayleaf,  292 
Beans,  207,  216 

broad,  218 

kidney,  216 

string,  216 
Beef,  20 

extract  of,  74 

fat,  141 

tea,  68 
Beer,  337 


Beet-root,  249,  250 
Beri-beri,  181 
Beverages,  308 

alcoholic,  316 
Bilberries,  269 
Biscuits,  200 
Bitters,  323 
Black  wheat,  182 
Boletus,  esculent,  224 
Bordeaux,  327 
Bouillon,  68 
Bourgogne,  327,  328 
Brains,  55 
Bread,  184 

alimentary  value  of,  185 

composition  of,  185 

rye,  181 

stale,  187 

white,  194 
Brioche,  203 
Brussels  sprouts,  246 
Buckwheat,  182 
Bullheads,  80 
Butcher's  meat,  19 
Butter,  96,  141,  142 

brown,  143 

hot,  142 

melted,  142 

milk,  126 

vegetable,  143 
Butyrin,  141 

Cabbage,  245 

red,  294 
Cacao  bean,  304 

butter,  304 
Caffein,  296 
Caffeinism,  299 
Caffeotannic  acid,  296 
Cakes,  202 

Caloric  coefficients,  9 
Calories,  ratio  of,  7 


375 


376 


INDEX 


Capers,  254,  292 
Carbohydrates,  20,  22 
Carp,  80 
Carrots,  249 
Catafia,  323 
Catfish,  80 
Caviar,  292,  293 
Celery,  249,  251 
Cellulose,  168,  218 
Cereal  decoctions,  232 
Cerealin,  186 
Cereals,  166 

general  characteristics, 
167 

special  characteristics,  175 
Champagne,  327,  328 
Champignon,  254 
Chartreuse,  323 
Cheese,  134-138 
Cherries,  257,  269 
Chestnuts,  206 
Chevril,  292 
Chicken,  61 
Chicory,  251 
Chocolate,  304 
Cider,  342 
Cinnamon,  292 
Citron,  292 
Cloves,  292 
Coal-fish,  80 
Cocoa,  304 
Codfish,  80 

Coefficients,  caloric,  9 
Coffee,  295 
Cognac,  323 
Condiments,  282 

assorted,  292 
Cookies,  202 
Corn,  180 

bread,  180 

salad,  252 
Crabs,  88 
Crackers^  200 
Cranberries,  269 
Cress,  251 
Crustaceans,  88 
Curasao,  323 

Dandelion,  252 
D'Asti,  328 
Dates,  278 
Decoctions,  cereal,  232 


Delicatessen,  57 
Diet,  dry,  310 
milk,  113 
Dragees,  202 
Dry  diet,  310 
Duck,  61 
Dulcine,  291 

Eel,  85 
Egg,  151 

flip,  156 

mulled,  156 

plant,  253 

test  of,  158 
Esculent  boletus,  254 
Extract  of  beef,  74 

of  meat,  68 
Extractive  substances,  21 

Farinaceous  foods,  227 
Fats,  141 

animal,  141 

reactions,  144 
Feeding,  rational,  5 
Figs,  278 
Fish,  79 

fatty,  85 

less  fatty,  85 
Fondants,  202 
Fowl,  61 
Fritters,  202 
Fruits,  256 

acidulated,  257 

cooked,  260 

fresh,  260 

neutral,  278 

oily,  279 

percentage  of  sugar,  265 

preserved,  261 

saccharine,  278 

sterilized,  261 

watery,  257 

Galantine,  248 
Galettes,  182 
Game,  64 

hanging  of,  65 
Garlic,  248 
Gelatin,  50 
Genoa  cake,  203 
Gers,  327 
Gherkins,  254,  292 


INDEX 


377 


Ginger,  292,  293 

bread,  203 

snaps,  203 
Glands,  50 
Glossary,  363 
Gluten,  185 
Goldfish,  80 
Goose,  61 

Gooseberries,  257,  272 
Grape  cure,  275 
Grapes,  257,  274 
Crayfish,  89 
Grease,  141 
Guanin,  21 
Gudgeon,  80 

Ham,  49 

Hare,  jugged,  64 
Hazlenuts,  279 
Head  cheese,  59 
Heart,  50 
Herring,  85 
Honey,  291 
Horse  meat,  47 
Horseradish,  292 
Huckleberries— see     Whortle- 
berries 

Hydration,  210 
Hygienic  beverages,  331 
Hypoxanthin,  21 

Juice  of  meat,  73 

Kemmerich,  pepton,  78 
Kephir,  128 
Kidneys,  52,  53 
Kirsch,  323 
Koumys,  131 
Kummel,  323 

Lecithin,  186 
Leek,  245,  248 
Legumes,  207 

in  childhood,  214 
Lemons,  257,  270 
Lentils,  215 
Lettuce,  222 
Liebig's  beef-juice,  75 
Liqueurs,  323 

sweetened,  323 
Liver,  52 
Lobster,  88 


Macaroni,  204 
Mackerel,  85 

Spanish,  85 
Madeira,  328 
Madeleines,  203 
Maize,  180 
Malt  Extract,  339 
Maltose,  337 
Mandarins,  272 
Manioc,  227 
Maranta  indica,  227 
Margarin,  141 
Marrow,  56 
Marsala,  328 
Martinet's  recipe,  173 
Measures,  367 
Meat,  19 

extract  of,  68 

juice  of,  73 

pie,  60 

powder,  75 

preserved,  44 

raw,  24 

red,  62 

refrigerated,  44 

smoked,  45 

white,  62 
Medoc,  328 
Melons,  252 
Meringues,  203 
Milk,  93 

adulterations  of,  107 

ass's,  101 

cow's,  95 

cryoscopic  analysis  of,  109 

curdled,  132 

derivatives  of,  126 

diet,  113 

food  for  infants,  117 

food  value  of,  94 

goat's,  102 

homogenized,  105 

how  to  use,  102 

in  influenza,  117 

in  New  York,  107 

mother's,  100 

pasteurization  of,  104 

powder,  106 

sterilization  of,  104 
Mineral  principles,  22 
Mullet,  85 
Mushrooms,  254 


378 


INDEX 


Mussels,  292 
Mutton,  48 
fat,  141 

Myoalbumin,  21 
Myosin,  21 
Myostroin,  21 

Narbonne,  328 
Needs  of  the  organism,  5 
Nerve  foods,  295 
Nitrogen,  22 

balance  of,  76 
Noodles,  204 
Nuclein,  21,  207 
Nursing,  117 

mixed,  118 

Nutritious  pastes,  204 
Nuts,  279 

Oatmeal,  176 
Oats,  175 
Oil,  141 
Olein,  141 
Oleomargarin,  143 
Olive-oil,  141 
Olives,  279 
Onions,  245,  247,  292 
Oranges,  257 
Oxalic  acid,  208 
Oyster-beds,  91 
Oysters,  88 

Pancakes,  202 
Pancreatin,  76 
Papain,  76 
Parsley,  292 
Partridge,  64 
Paste,  202 

Italian,  204 
Pastes,  nutritious,  204 
Pastry,  201 

home  made,  203 
Pate  de  fois  gras,  60 
Peaches,  257,  273 
Pears,  257,  273 
Pea  sausage,  57 
Peas,  207,  217 
Pellagra,  181 
Pepper,  292 

red,  293 
Peptones,  76 
Perch,  80 


Petits  fours,  202 
Pickles,  294 
Pickling  venison,  64 
Picon,  323 
Pigeon,  61 
Pike,  80 
Pineapple,  269 
Plaice,  80 
Plasmon,  77 
Platrage,  331 
Plums,  257,  273 
Polenta,  180 
Pork,  48 

fat,  141 
Porridge,  176 
Port,  327,  328 
Potato,  219 

fecula  of,  227 

sprouts,  226 
Poultry,  61 
Powder,  meat,  75 

milk,  106 
Pralines,  202 
Prawns,  88 
Prunes,  264,  273 
Ptomains,  44,  90 
Pudding,  black,  60 

blood,  60 
Pulse,  207 
Pumpernickel,  182 
Puric  bodies,  21 
Purins,  21,  22 

Quail,  64 
Quince,  257,  270 

Rabbit,  61 
Radishes,  238 
Raisins,  277 
Raspberries,  257,  271 
Ration,  composition  of,  15 

theoretical,  7 
Reactions,  alimentary,  10 

dechlorated,  287 
Regimen,  dry,  310 
Residues,  15 
Rhine  wines,  328 
Rhubarb,  251 
Rice,  177 

Richet's  recipe,  24 
Rum,  323 
Rye,  181 


INDEX 


379 


Rye  bread,  181 
ergotin,  182 

Sabayon,  157 
Saccharine,  291 
Salads,  251 
Salmon,  85 
Salsify,  249 
Salt,  283 
Sanatogen,  78 
Sardines,  80 
Sauer-kraut,  247 
Sausages,  59 
Savoy  cake,  203 
Shad,  85 
Shell-fish,  88 
Shrimps,  88 
Skate,  80 
Smelt,  80 
Snails,  88 
Solanin,  226 
Somatose,  78 
Sorrel,  251 
Soup,  68 

bottle,  70 

vegetable,  212 
Spanish  wines,  328 
Spinach,  251 

Starches,    Labbe's    classifica- 
tion of,  174 
Stearin,  141 
Strawberries,  257,  271 
Sugar,  288 
Sweetbread,  52,  54 
Sweetmeats,  202 

Tapioca,  204,  227 
Tarts,  203 
Tea,  301 

Ternary  bodies,  14 
Thein,  301 
Theobromin,  304 
Thrush,  64 
Tokay,  328 
Tomato,  252 
Tripe,  50 
Tropon,  78 


Trout,  80 
Truffles,  255 
Tunny,  85 
Turbot,  85 
Turkey,  61 
Turnips,  249 

Uric  acid,  21 

Vanilla,  292 

Veal,  46 

Vegetable  butter,  143 

soup,  232 
Vegetables,  green,  234 

particulars,  245 
Vegetarianism,  344 
Venison,  64 
Vermicelli,  204 
Vermouth,  323 
Vinegar,  292 

Walnuts,  279 
Water,  312 

boiled,  314 

drinking,  312 

natural,  308 

rain,  314 

river,  314 

use  of,  during  meals,  314 
Weights,  371 
Wheat,  182 

flour,  183 
Whey,  127 

cures,  128 
Whiting,  80 
Whortleberries,  269 
Wine,  327 

adulterations  of,  330 

artificial,  331 
Woodcock,  65 

Xanthic  bodies,  21 
Xanthin,  21 

Yoghourt,  132 
Zabaglione,  157 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 

Los  Angeles 

This  book  is  DUE  on  the  last 
date  stamped  below. 


REC'D  LD-LRI 

WlHK  ;-: 


1972 


MAY  11 


. 

JUN  i  51979 


10m-7,'70(N8464s8)-Z-53 


3 "11 58  00030  "2835 


UC  SOUTHERN  REGIONAL  LIBRARY  FACILITY 


A    001  377  767    7 


